Provider Demographics
NPI:1932157971
Name:BROWN, REBECCA (DEVELOPMENTAL THERAP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:DEVELOPMENTAL THERAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 N BRENTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-2514
Mailing Address - Country:US
Mailing Address - Phone:765-288-1026
Mailing Address - Fax:
Practice Address - Street 1:2000 N BRENTWOOD LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-2514
Practice Address - Country:US
Practice Address - Phone:765-288-1026
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist