Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 20042813A | IN |
Y | 103G00000X | Clinical Psychologist | 20042813A | IN |
Y | 103TC0700X | Clinical Psychologist | 20042813A | IN |
NPI | 1184266512 |
---|---|
Provider Name | Dr. Brittany Michelle Brothers |
First Address | Bloomington, IN 47401-4316 |
Second Address | Bloomington, IN 47405-7007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2019 |
Last Update Date | 17/10/2019 |