Provider Demographics
NPI:1710122841
Name:BROWN, KALEENA NAOMI (SLP)
Entity Type:Individual
Prefix:MS
First Name:KALEENA
Middle Name:NAOMI
Last Name:BROWN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 VESTAL AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-1941
Mailing Address - Country:US
Mailing Address - Phone:607-723-8313
Mailing Address - Fax:
Practice Address - Street 1:1295 VESTAL AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1941
Practice Address - Country:US
Practice Address - Phone:607-723-8313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018450-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist