Provider Demographics
NPI:1124426648
Name:BRIARWOOD, KIM E (MA)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:E
Last Name:BRIARWOOD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18598 NORTHRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CEDAREDGE
Mailing Address - State:CO
Mailing Address - Zip Code:81413-8225
Mailing Address - Country:US
Mailing Address - Phone:970-901-0645
Mailing Address - Fax:
Practice Address - Street 1:18598 NORTHRIDGE RD
Practice Address - Street 2:
Practice Address - City:CEDAREDGE
Practice Address - State:CO
Practice Address - Zip Code:81413-8225
Practice Address - Country:US
Practice Address - Phone:970-901-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health