Provider Demographics
NPI:1144790262
Name:ROWBOTHAM, BRANDY LEE ISABELLA
Entity Type:Individual
Prefix:MISS
First Name:BRANDY LEE
Middle Name:ISABELLA
Last Name:ROWBOTHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01862-1202
Mailing Address - Country:US
Mailing Address - Phone:978-955-1592
Mailing Address - Fax:
Practice Address - Street 1:232 HIGH ST
Practice Address - Street 2:
Practice Address - City:NORTH BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01862-1202
Practice Address - Country:US
Practice Address - Phone:978-955-1592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-01
Last Update Date:2018-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS89685520106S00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician