Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 5593 | OH |
Y | 103G00000X | Clinical Psychologist | 5593 | OH |
Y | 103TC0700X | Clinical Psychologist | 5593 | OH |
NPI | 1558547885 |
---|---|
Provider Name | Dr. Sherry Knapp-Brown |
First Address | Fairfield, OH 45014-3356 |
Second Address | Mason, OH 45040-3104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2008 |
Last Update Date | 07/03/2021 |