Individual
EMERY QIAN BRAUTIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.ED
Contact information
Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1888
(443) 923-1870
Mailing address
7900 ERIN MICHELE PKWY APT 420, SEVERN, MD 21144-1275
(817) 471-8268
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
07442
MD
106S00000X
Behavior Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
MD
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/19/2019
Last updated
04/20/2026
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