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General NPI Number Information
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NPI Number | 1669512331
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Entity Type | Individual
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Provider Name | JENNIFER LYNN BROWN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 25 BOND ST
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City | SPRINGFIELD
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State | MA
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Zip | 01104-3401
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Country | US
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Telephone | 413-731-6087
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Fax |
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Provider Business Mailing Address
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Address Line | 421 N MAIN ST
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City | LEEDS
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State | MA
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Zip | 01053-9764
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Country | US
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Telephone | 413-584-4040
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 8682
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | 8682
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License Number State | MA
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