Individual provider · NPI-1

Shante A Brown

Behavior Technician · Newark, NJ

NPI number1124879036
StatusActive
Last updated in NPPESMar 28, 2024

Details

NPI
1124879036
Entity type
Individual (NPI-1)
Name
Shante A Brown
Sex
Female
Sole proprietor
No
Enumeration date
Mar 28, 2024
Certification date
Mar 28, 2024
Last updated
Mar 28, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician728537534NYYes

Practice location

915 Broad St Apt 402
Newark, NJ 07102-2695

Phone 917-420-1361

Mailing address

100 International Dr
Budd Lake, NJ 07828-1383

Phone 223-333-2828

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