Individual
BRIDGET DENISE MANGRUM BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
12318 BOYDTON PLANK RD, DINWIDDIE, VA 23841-2454
(540) 369-2389
(877) 734-1914
Mailing address
12318 BOYDTON PLANK RD, DINWIDDIE, VA 23841-2454
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36049
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619476090
—
VA
Enumeration date
02/12/2018
Last updated
08/21/2023
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