Provider Demographics
NPI:1912480088
Name:BROWN, BEVERLY JANE
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JANE
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 1:1430 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5599
Mailing Address - Country:US
Mailing Address - Phone:509-888-1627
Mailing Address - Fax:
Practice Address - Street 1:1430 1ST ST SE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5599
Practice Address - Country:US
Practice Address - Phone:509-888-1627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist