Provider Demographics
NPI:1205455136
Name:BROWN, TIFFANY MORGAN (RBT, BS)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:MORGAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RBT, BS
Other - Prefix:MRS
Other - First Name:TIFFANY
Other - Middle Name:MORGAN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT, BS
Mailing Address - Street 1:407 GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6109
Mailing Address - Country:US
Mailing Address - Phone:609-703-1827
Mailing Address - Fax:
Practice Address - Street 1:407 GLENN AVE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-6109
Practice Address - Country:US
Practice Address - Phone:609-703-1827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty