Organization
BRAIN ANALYSIS AND NEURODEVELOPMENT CENTER, LLC
Active
Organization
BRAIN ANALYSIS AND NEURODEVELOPMENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT W. DAVIS PSY.D. (DIRECTOR)
(413) 835-0520
Entity
Organization
Contact information
Practice address
20 GATEHOUSE RD, LOWER LEVEL, AMHERST, MA 01002-2879
(413) 835-0520
(413) 835-0569
Mailing address
20 GATEHOUSE RD, LOWER LEVEL, AMHERST, MA 01002-2879
(413) 835-0520
(413) 835-0569
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7324
MA
103TC2200X
Clinical Child & Adolescent Psychologist
8195
MA
103TH0004X
Health Psychologist
7324
MA
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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