Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 103K00000X | Behavior Analyst | ||
Y | 103TC1900X | Counseling Psychologist | 261-4781399 | ZZ |
N | 103TF0200X | Forensic Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | ||
N | 103TP0016X | Prescribing (Medical) | ||
N | 103TP0814X | Psychoanalysis | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1336524495 |
---|---|
Provider Name | Anitra Nicole Brown |
First Address | Amherst, MA 01002-3114 |
Second Address | Amherst, MA 01002-3114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2015 |
Last Update Date | 07/08/2015 |