Provider Demographics
NPI:1598771826
Name:BROWN, PETER A (MS CCC/SLP)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 SOUTH RIVER STREET
Mailing Address - Street 2:PO BOX 153
Mailing Address - City:MAYTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17550
Mailing Address - Country:US
Mailing Address - Phone:717-426-1652
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER #726
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007272235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist