Provider Demographics
NPI:1326861725
Name:BROWN, SAMANTHA A (MSED, BCBA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 ROUTE 58 EAST
Mailing Address - Street 2:
Mailing Address - City:IRASBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05845
Mailing Address - Country:US
Mailing Address - Phone:802-505-9222
Mailing Address - Fax:
Practice Address - Street 1:251 ROUTE 58 EAST
Practice Address - Street 2:
Practice Address - City:IRASBURG
Practice Address - State:VT
Practice Address - Zip Code:05845
Practice Address - Country:US
Practice Address - Phone:802-505-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst