Provider Demographics
NPI:1528701224
Name:BROWNE, SAMANTHA L (BCBA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:L
Last Name:BROWNE
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 1:29681 N WAUKEGAN RD APT 206
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-5482
Mailing Address - Country:US
Mailing Address - Phone:224-374-3713
Mailing Address - Fax:
Practice Address - Street 1:770 LAKE COOK RD STE 230
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4976
Practice Address - Country:US
Practice Address - Phone:847-961-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst