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General NPI Number Information
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NPI Number | 1134518624
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Entity Type | Individual
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Provider Name | KRISTOPHER BROWN PSY.D., BCBA-D, LP
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Gender | Male
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 5500 MARKET ST STE 119
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City | BOARDMAN
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State | OH
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Zip | 44512-2616
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Country | US
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Telephone | 330-991-9117
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Fax |
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Provider Business Mailing Address
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Address Line | 5286 S SARATOGA AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-4076
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Country | US
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Telephone | 330-257-5330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | P.08535
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License Number State | OH
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