Provider Demographics
NPI:1023291341
Name:CHAN-BROWN, BETTY (CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:
Last Name:CHAN-BROWN
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 ADMIRAL COCHRANE DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7365
Mailing Address - Country:US
Mailing Address - Phone:410-571-6411
Mailing Address - Fax:410-571-6415
Practice Address - Street 1:190 ADMIRAL COCHRANE DR
Practice Address - Street 2:SUITE 180
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7365
Practice Address - Country:US
Practice Address - Phone:410-571-6411
Practice Address - Fax:410-571-6415
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04772235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist