Brown, Jacklyn
Brown, Jacklyn is an sole proprietor health care provider with primary practice located at 454 Brockton Dr , Middletown DE 19709-8369. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, which is considered as her primary health care specialty. Brown, Jacklyn can be contacted via phone (856) 979-5112.Contact Information
Primary practice address
454 Brockton Dr
Middletown DE 19709-8369
Phone: (856) 979-5112
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities | 103TM1800X | Delaware |
Profile Details
| NPI number | 1275132284 |
|---|---|
| LBN Legal business name | Brown, Jacklyn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 21st, 2020 |
| Last updated | Oct 21st, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275132284 | NPPES |
| Delaware | MEDICAID | 250567338 |
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