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Individual

DEMETRA BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
X

Contact information

Practice address
634 N MAIN ST STE 4, O FALLON, IL 62269-3746
(618) 726-5870
Mailing address
28 LOUISE LN, CAHOKIA, IL 62206-2737

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
IL

Other

Enumeration date
06/02/2026
Last updated
06/02/2026
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