Provider Demographics
NPI:1477869964
Name:AUFDERHAR, BRENDA JEAN
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:JEAN
Last Name:AUFDERHAR
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 1:707 W 7TH AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2821
Mailing Address - Country:US
Mailing Address - Phone:509-670-9446
Mailing Address - Fax:
Practice Address - Street 1:707 W 7TH AVE STE 150
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2821
Practice Address - Country:US
Practice Address - Phone:509-670-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health