Provider Demographics
NPI:1700371192
Name:BROWN, AMBER A (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MRS
Other - First Name:AMBER
Other - Middle Name:A
Other - Last Name:SEARCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT, BCABA, BCBA
Mailing Address - Street 1:PO BOX 5042
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-5042
Mailing Address - Country:US
Mailing Address - Phone:678-570-7417
Mailing Address - Fax:
Practice Address - Street 1:1201 SHADOWLAWN DR STE 112
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4074
Practice Address - Country:US
Practice Address - Phone:912-409-7889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0-18-8878103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst