Provider Demographics
NPI:1831745645
Name:MURPHY, BRIAN DOUGLAS (BT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:DOUGLAS
Last Name:MURPHY
Suffix:
Gender:M
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PLEASANT WOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORESTDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02644-1227
Mailing Address - Country:US
Mailing Address - Phone:774-521-7418
Mailing Address - Fax:
Practice Address - Street 1:22 PLEASANT WOOD DR
Practice Address - Street 2:
Practice Address - City:FORESTDALE
Practice Address - State:MA
Practice Address - Zip Code:02644-1227
Practice Address - Country:US
Practice Address - Phone:774-521-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst