Provider Demographics
NPI:1194858050
Name:BRAHAM, DAVID LOIUS (MS, PLMFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LOIUS
Last Name:BRAHAM
Suffix:
Gender:M
Credentials:MS, PLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 HICKOK DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-4232
Mailing Address - Country:US
Mailing Address - Phone:970-402-3168
Mailing Address - Fax:
Practice Address - Street 1:804 11TH AVE
Practice Address - Street 2:TRANSITIONS PSYCHOLOGY GROUP
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-3246
Practice Address - Country:US
Practice Address - Phone:970-402-3168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1006106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist