Provider Demographics
NPI:1891257960
Name:BROWN, ALEXIA ERIANA
Entity Type:Individual
Prefix:MS
First Name:ALEXIA
Middle Name:ERIANA
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 1:16763 WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-2762
Mailing Address - Country:US
Mailing Address - Phone:708-296-0431
Mailing Address - Fax:
Practice Address - Street 1:8505 183RD ST STE D
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-9353
Practice Address - Country:US
Practice Address - Phone:708-864-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician