Provider Demographics
NPI:1669672499
Name:BROWN, ANASTASIA JAEL (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:JAEL
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:J
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:11 ASHWORTH CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3484
Mailing Address - Country:US
Mailing Address - Phone:936-271-0222
Mailing Address - Fax:
Practice Address - Street 1:11 ASHWORTH CT
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77385-3484
Practice Address - Country:US
Practice Address - Phone:936-271-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101282235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist