Individual
JACKLYN BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
454 BROCKTON DR, MIDDLETOWN, DE 19709-8369
(856) 979-5112
Mailing address
454 BROCKTON DR, MIDDLETOWN, DE 19709-8369
(856) 979-5112
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250567338
—
DE
Enumeration date
10/21/2020
Last updated
10/21/2020
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