Provider Demographics
NPI:1922635085
Name:BROWN, JOURDEN MAXIE
Entity Type:Individual
Prefix:
First Name:JOURDEN
Middle Name:MAXIE
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 1:208 BELLE ISLE CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4858
Mailing Address - Country:US
Mailing Address - Phone:702-596-2201
Mailing Address - Fax:
Practice Address - Street 1:208 BELLE ISLE CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-4858
Practice Address - Country:US
Practice Address - Phone:702-596-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician