Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY642 | ME |
Y | 103TC0700X | Clinical Psychologist | PSY642 | ME |
NPI | 1013115401 |
---|---|
Provider Name | Dr. Ronald James Brown |
First Address | Bangor, ME 04401-6357 |
Second Address | Bangor, ME 04401-6357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2007 |
Last Update Date | 08/07/2007 |