Provider Demographics
NPI:1346984473
Name:BROWN, LAJARVIA (BCBA)
Entity type:Individual
Prefix:
First Name:LAJARVIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 COUNTY ROAD 58
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-2927
Mailing Address - Country:US
Mailing Address - Phone:346-642-6522
Mailing Address - Fax:
Practice Address - Street 1:3405 COUNTY ROAD 58
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-2927
Practice Address - Country:US
Practice Address - Phone:346-642-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2024-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXRBT-21-183441OtherRBT