Provider Demographics
NPI:1356141766
Name:BRANDT, VICTORIA LEIGH
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LEIGH
Last Name:BRANDT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704 N 83RD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1712
Mailing Address - Country:US
Mailing Address - Phone:480-229-1990
Mailing Address - Fax:
Practice Address - Street 1:1440 E MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2458
Practice Address - Country:US
Practice Address - Phone:480-448-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional