Provider Demographics
NPI:1285997726
Name:BRENT, TIMOTHY SR
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:BRENT
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17908 E AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-2122
Mailing Address - Country:US
Mailing Address - Phone:720-324-3755
Mailing Address - Fax:
Practice Address - Street 1:17908 E AMHERST AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-2122
Practice Address - Country:US
Practice Address - Phone:720-324-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health