Provider Demographics
NPI:1831506880
Name:BRITWUM, KWADWO O
Entity type:Individual
Prefix:
First Name:KWADWO
Middle Name:O
Last Name:BRITWUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 MILL ISLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3226
Mailing Address - Country:US
Mailing Address - Phone:630-701-5763
Mailing Address - Fax:
Practice Address - Street 1:2007 MILL ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3226
Practice Address - Country:US
Practice Address - Phone:630-701-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABH000527OtherSTATE BOARD OF MEDICINE
PA1-15-20865OtherBEHAVIOR ANALYST CERTIFICATION BOARD (BACB)