Provider Demographics
NPI:1659413474
Name:BRUCE-SANFORD, GAIL (PHD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:
Last Name:BRUCE-SANFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2769 S VICTOR ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3435
Mailing Address - Country:US
Mailing Address - Phone:303-941-6349
Mailing Address - Fax:303-750-6313
Practice Address - Street 1:2600 S PARKER RD
Practice Address - Street 2:BLDG.2, SUITE 221
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1613
Practice Address - Country:US
Practice Address - Phone:303-941-6349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2387103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist