Provider Demographics
NPI:1093041089
Name:BRIMMER, CECILIA RENEE
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:RENEE
Last Name:BRIMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-4851
Mailing Address - Country:US
Mailing Address - Phone:307-262-6347
Mailing Address - Fax:307-333-1381
Practice Address - Street 1:1751 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-4851
Practice Address - Country:US
Practice Address - Phone:307-262-6347
Practice Address - Fax:307-333-1381
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator