Provider Demographics
NPI:1871829358
Name:BROWN, CHERELLE (BCABA)
Entity Type:Individual
Prefix:
First Name:CHERELLE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 ARLINGTON CENTRE BLVD
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3075
Mailing Address - Country:US
Mailing Address - Phone:614-615-5145
Mailing Address - Fax:614-573-4114
Practice Address - Street 1:5000 ARLINGTON CENTRE BLVD
Practice Address - Street 2:BUILDING 2
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-3075
Practice Address - Country:US
Practice Address - Phone:614-615-5145
Practice Address - Fax:614-573-4114
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicaid