Healthcare Provider Details

I. General information

NPI: 1659413474
Provider Name (Legal Business Name): GAIL BRUCE-SANFORD PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 S PARKER RD BLDG.2, SUITE 221
AURORA CO
80014-1613
US

IV. Provider business mailing address

2769 S VICTOR ST
AURORA CO
80014-3435
US

V. Phone/Fax

Practice location:
  • Phone: 303-941-6349
  • Fax:
Mailing address:
  • Phone: 303-941-6349
  • Fax: 303-750-6313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2387
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: