Individual
RUSSELL BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 CENTER ST, AUBURN, ME 04210-6404
(207) 782-2726
(207) 333-3501
Mailing address
415 RODMAN RD, AUBURN, ME 04210-3942
(207) 782-2726
(207) 333-3501
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-8321
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#1-11-8321
BCBA
ME
Enumeration date
03/17/2011
Last updated
03/17/2011
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