Provider Demographics
NPI:1942973524
Name:BROWN, CALEIGH
Entity type:Individual
Prefix:
First Name:CALEIGH
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11365 LITTLE PATUXENT PKWY APT 714
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3966
Mailing Address - Country:US
Mailing Address - Phone:240-479-6764
Mailing Address - Fax:
Practice Address - Street 1:9140 GUILFORD RD STE O
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2584
Practice Address - Country:US
Practice Address - Phone:888-823-6996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD68216704Medicaid