Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 36123 | TX |
N | 103T00000X | Psychologist | 36123 | TX |
Y | 103G00000X | Clinical Psychologist | 36123 | TX |
Y | 103TC0700X | Clinical Psychologist | 36123 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 36123 | TX |
NPI | 1013256312 |
---|---|
Provider Name | Amy G Brown |
First Address | Austin, TX 78750-1873 |
Second Address | Austin, TX 78750-1873 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2013 |
Last Update Date | 24/01/2018 |