Provider Demographics
NPI:1679189377
Name:SANDRA J BRIM, PSYCHOLOGY, P.C.
Entity Type:Organization
Organization Name:SANDRA J BRIM, PSYCHOLOGY, P.C.
Other - Org Name:SANDRA J. BRIM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:424-355-3697
Mailing Address - Street 1:321 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537
Mailing Address - Country:US
Mailing Address - Phone:424-355-3697
Mailing Address - Fax:970-966-8905
Practice Address - Street 1:321 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537
Practice Address - Country:US
Practice Address - Phone:424-355-3697
Practice Address - Fax:970-966-8905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty