Provider Demographics
NPI:1770074692
Name:SWINT, BRANDI H
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:H
Last Name:SWINT
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 1:18510 ARROWWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8793
Mailing Address - Country:US
Mailing Address - Phone:931-920-8460
Mailing Address - Fax:
Practice Address - Street 1:18510 ARROWWOOD DR
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8793
Practice Address - Country:US
Practice Address - Phone:931-920-8460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18-56552106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician