Provider Demographics
NPI:1891046645
Name:BROWN, DENA LENORE (BCBA)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:LENORE
Last Name:BROWN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 OLD EMBRYVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37659-2010
Mailing Address - Country:US
Mailing Address - Phone:302-545-5420
Mailing Address - Fax:
Practice Address - Street 1:189 OLD EMBREEVILLE RD
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-6191
Practice Address - Country:US
Practice Address - Phone:302-545-5420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst