Provider Demographics
NPI:1043398928
Name:BRUFF, SANDRA M (LPC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:BRUFF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-3807
Mailing Address - Country:US
Mailing Address - Phone:662-844-4254
Mailing Address - Fax:662-844-4254
Practice Address - Street 1:211 N MADISON ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-3807
Practice Address - Country:US
Practice Address - Phone:662-844-4254
Practice Address - Fax:662-844-4254
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional