Doctor Name: | MR. JOHN MICHAEL BRAWLEY |
NPI Number: | 1174891139 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMSW |
License Number: | 062158-1 |
Business Practice Address: | 20 Farm To Market Rd Brewster, NY - 105092703 |
Business Phone Number: | 8452794018 |
Business Fax Number: | |
Mailing Address: | 20 Farm To Market Rd, BREWSTER |
State: | NY |
Postal Code: | 105092703 |
Phone Number: | 8452794018 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2011 |
NPI Last Update Date: | 12/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 062158-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |