Doctor Name: | DR. BRADLEY JOHN CRENSHAW |
NPI Number: | 1215994207 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 6679 |
Business Practice Address: | 79 S Pleasant St Suite 6 Amherst, MA - 010022370 |
Business Phone Number: | 4132591017 |
Business Fax Number: | 4132591017 |
Mailing Address: | 20 Maplewood Dr, AMHERST |
State: | MA |
Postal Code: | 010021843 |
Phone Number: | 4135494146 |
Fax Number: | |
NPI Enumeration Date: | 04/26/2006 |
NPI Last Update Date: | 12/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 6679 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |