Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 001494 | CT |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6892 | MA |
NPI | 1144453325 |
---|---|
Provider Name | Dr. Joseph Brown |
First Address | Springfield, MA 01138-0971 |
Second Address | Hartford, CT 06105-4288 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2009 |
Last Update Date | 03/09/2009 |