Provider Demographics
NPI:1013723857
Name:BROWN, JOSHUA D (MS, BCBA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2767 E US HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:KENDALLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46755-9341
Mailing Address - Country:US
Mailing Address - Phone:260-308-8889
Mailing Address - Fax:
Practice Address - Street 1:2767 E US HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:KENDALLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46755-9341
Practice Address - Country:US
Practice Address - Phone:260-308-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-24-75278103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst