Individual
LORI KIM BRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4150 W PEORIA AVE, STE 133, PHOENIX, AZ 85029-3900
(602) 910-0526
Mailing address
3215 W RAPALO RD, PHOENIX, AZ 85086-2213
(602) 910-0526
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4055
AZ
103TC0700X
Clinical Psychologist
7796313-2501
UT
Other
Enumeration date
09/12/2009
Last updated
05/24/2015
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