Provider Demographics
NPI:1528307998
Name:TINSON-DELOOZE, BRANDYE
Entity type:Individual
Prefix:MRS
First Name:BRANDYE
Middle Name:
Last Name:TINSON-DELOOZE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BRANDYE
Other - Middle Name:EDWENA
Other - Last Name:TINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2505 ANTHEM VILLAGE DR STE E166
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5505
Mailing Address - Country:US
Mailing Address - Phone:619-944-7148
Mailing Address - Fax:
Practice Address - Street 1:3488 ALGHERO AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-1795
Practice Address - Country:US
Practice Address - Phone:619-944-7148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3039106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist