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General NPI Number Information
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NPI Number | 1144698739
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Entity Type | Individual
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Provider Name | TIFFANY BRIMBERRY PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/13/2015
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 13611 E 104TH AVE UNIT 100
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City | COMMERCE CITY
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State | CO
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Zip | 80022
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Country | US
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Telephone | 720-593-4673
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Fax |
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Provider Business Mailing Address
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Address Line | 245 N OAK HILL WAY
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City | AURORA
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State | CO
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Zip | 80018-1785
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Country | US
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Telephone | 303-875-8936
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY.0004679
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License Number State | CO
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