Provider Demographics
NPI:1063800753
Name:BRANDY LIEBSCHER, PSYD
Entity type:Organization
Organization Name:BRANDY LIEBSCHER, PSYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-351-2885
Mailing Address - Street 1:163 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3316
Mailing Address - Country:US
Mailing Address - Phone:206-851-5425
Mailing Address - Fax:
Practice Address - Street 1:163 2ND ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3316
Practice Address - Country:US
Practice Address - Phone:206-851-5425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-03
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF8373719250251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health