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General NPI Number Information
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NPI Number | 1891264313
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Entity Type | Individual
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Provider Name | MAXWELL ANDERSON BROOKS PSYD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 7801 NORFOLK AVE STE 102
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City | BETHESDA
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State | MD
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Zip | 20814-6059
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Country | US
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Telephone | 301-684-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 WILSON BLVD UNIT 330
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City | ARLINGTON
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State | VA
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Zip | 22201-6606
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Country | US
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Telephone | 617-320-6190
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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 | 0810-006038
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 06186
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License Number State | MD
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