Provider Demographics
NPI:1689329005
Name:BROWN, JOHNAH
Entity Type:Individual
Prefix:
First Name:JOHNAH
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HAYNES SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:KY
Mailing Address - Zip Code:42327-9718
Mailing Address - Country:US
Mailing Address - Phone:270-499-1844
Mailing Address - Fax:
Practice Address - Street 1:601 HAYNES SCOTT RD
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:KY
Practice Address - Zip Code:42327-9718
Practice Address - Country:US
Practice Address - Phone:270-499-1844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist