Provider Demographics
NPI:1043436728
Name:BRINTHAUPT, VIRGINIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:BRINTHAUPT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11332
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0027
Mailing Address - Country:US
Mailing Address - Phone:615-867-4707
Mailing Address - Fax:
Practice Address - Street 1:304B UPTOWN SQ
Practice Address - Street 2:SUITE 5
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0574
Practice Address - Country:US
Practice Address - Phone:615-867-4707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1536103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling