Brown, Marquita Tavisia
Brown, Marquita Tavisia is an sole proprietor health care provider with primary practice located at 1105 E St Nw , Ardmore OK 73401-4267. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is her primary health care specialty. Brown, Marquita Tavisia can be contacted via phone (580) 630-4089.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X | ||
| Other Service Providers / Peer Specialist | 175T00000X |
Profile Details
| NPI number | 1821715210 |
|---|---|
| LBN Legal business name | Brown, Marquita Tavisia |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 26th, 2022 |
| Last updated | Dec 1st, 2022 - about 3 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 | 1821715210 | NPPES |
| Oklahoma | Other | A926225446 | OKLAHOMA DEPARTMENT OF PUBLIC SAFETY |
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