Doctor Name: | LINDA MACK BREWER |
NPI Number: | 1689045478 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 5875 |
Business Practice Address: | 2218 W Grand Ave Artesia, NM - 882101624 |
Business Phone Number: | 5757486100 |
Business Fax Number: | |
Mailing Address: | 3300 N Atkinson Ave Apt 5, ROSWELL |
State: | NM |
Postal Code: | 882017816 |
Phone Number: | 8434715566 |
Fax Number: | |
NPI Enumeration Date: | 10/19/2015 |
NPI Last Update Date: | 10/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5875 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |