Provider Demographics
NPI:1194114009
Name:BROWN, ANNA CASSIDY (MA BCBA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CASSIDY
Last Name:BROWN
Suffix:
Gender:
Credentials:MA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 JONES RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0705
Mailing Address - Country:US
Mailing Address - Phone:479-318-2300
Mailing Address - Fax:479-763-0059
Practice Address - Street 1:1022 JONES RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0705
Practice Address - Country:US
Practice Address - Phone:479-318-2300
Practice Address - Fax:479-763-0059
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1-18-30825103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst