Doctor Name: | DR. WILLIAM LOUIS BRIM |
NPI Number: | 1174514392 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | 2608 |
Business Practice Address: | 301 Steeple Chase Dr Suite 104 Prince Frederick, MD - 206784049 |
Business Phone Number: | 4105701163 |
Business Fax Number: | |
Mailing Address: | Po Box 1295, HUNTINGTOWN |
State: | MD |
Postal Code: | 206391295 |
Phone Number: | 4105701163 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2005 |
NPI Last Update Date: | 01/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 2608 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |