Provider Demographics
NPI:1033531405
Name:LUJAN, BRANDY L
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:L
Last Name:LUJAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:L
Other - Last Name:WILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BC-HIS
Mailing Address - Street 1:2532 PATTERSON RD
Mailing Address - Street 2:12
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-3604
Mailing Address - Country:US
Mailing Address - Phone:970-243-6440
Mailing Address - Fax:
Practice Address - Street 1:2532 PATTERSON RD
Practice Address - Street 2:12
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-3604
Practice Address - Country:US
Practice Address - Phone:970-243-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist