Provider Demographics
NPI:1255853826
Name:BRICKMAN, ANGELA KATHRYN (RBT-17-36119)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KATHRYN
Last Name:BRICKMAN
Suffix:
Gender:F
Credentials:RBT-17-36119
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 RIDGESIDE DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5758
Mailing Address - Country:US
Mailing Address - Phone:303-503-6623
Mailing Address - Fax:
Practice Address - Street 1:714 RIDGESIDE DRIVE
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401
Practice Address - Country:US
Practice Address - Phone:303-503-6623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-17-36119106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician