Doctor Name: | VICKIE RENEA BREWER |
NPI Number: | 1265470082 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | P2103 |
Business Practice Address: | 777 Washington Avenue Suite P235 Memphis, TN - 38105 |
Business Phone Number: | 9012875220 |
Business Fax Number: | 9012874502 |
Mailing Address: | 582 Whittenburg Dr, COLLIERVILLE |
State: | TN |
Postal Code: | 38017 |
Phone Number: | 9012875220 |
Fax Number: | 9012874502 |
NPI Enumeration Date: | 06/03/2006 |
NPI Last Update Date: | 07/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | P2103 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |