Provider Demographics
NPI:1831846286
Name:POINDEXTER-BROWN, MARITZA (MFTA)
Entity type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:POINDEXTER-BROWN
Suffix:
Gender:F
Credentials:MFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6611
Mailing Address - Country:US
Mailing Address - Phone:203-368-5573
Mailing Address - Fax:
Practice Address - Street 1:125 PENFIELD RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6611
Practice Address - Country:US
Practice Address - Phone:203-368-5573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2817106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist