Doctor Name: | LAURA G. BREWER |
NPI Number: | 1093998593 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | 2646-057 |
Business Practice Address: | 101 E Pier St Port Washington, WI - 530741939 |
Business Phone Number: | 2622843117 |
Business Fax Number: | 2622843087 |
Mailing Address: | 285 N Janacek Rd, BROOKFIELD |
State: | WI |
Postal Code: | 530456102 |
Phone Number: | 2626419050 |
Fax Number: | |
NPI Enumeration Date: | 12/07/2007 |
NPI Last Update Date: | 12/07/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 2646-057 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |