Provider Demographics
NPI:1548680093
Name:BRANDT, TIFFANY DAWN WEST (PHD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:DAWN WEST
Last Name:BRANDT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:DAWN
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8201 NORTHWOODS DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-3092
Mailing Address - Country:US
Mailing Address - Phone:402-465-5600
Mailing Address - Fax:402-327-6074
Practice Address - Street 1:4020 HOHENSEE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3927
Practice Address - Country:US
Practice Address - Phone:402-465-5600
Practice Address - Fax:402-327-6074
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE986103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist