Individual
JELISA MARIE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-A
Contact information
Practice address
7220 NW 114TH AVE # 20216, DORAL, FL 33178-5562
(787) 439-2552
Mailing address
7220 NW 114TH AVE # 20216, DORAL, FL 33178-5562
(787) 439-2552
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI5506
FL
235Z00000X
Speech-Language Pathologist
7523
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7866
—
SC
Enumeration date
03/01/2021
Last updated
06/08/2022
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