Tabitha Ann Brown

Individual provider Active NPI Behavior Technician · Northford, CT

NPI 1730624263 · NPPES record last updated Dec 19, 2016

Key facts

NPI
1730624263
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
106S00000X (CT)
Practice address
9 Robin LN
10
Northford, CT 06472
Phone
(603) 762-1627
NPI assigned
Dec 19, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
106S00000XCTMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 106S00000X CT Yes

Addresses

Primary practice location

9 Robin LN
10
Northford, CT 06472

Mailing address

9 Robin LN
Northford, CT 06472-1426
Phone (603) 762-1627

Other providers in Northford, CT

All providers in Northford, CT · Behavior Technician in Connecticut

Sources for this page

Verify at the official NPI Registry.