Individual
SHAWNNA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9393 BELOIT RD, BELVIDERE, IL 61008-9735
(815) 547-3843
Mailing address
919 JORDAN PL, ROCKFORD, IL 61108-3705
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2384582
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811165061
—
IL
Enumeration date
12/22/2017
Last updated
12/22/2017
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