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NPI Code Detail

MEDICARE: MRS. KATRINA J BREWER LPC

MEDICARE: MRS. KATRINA J BREWER LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLAC-13244AZ
2101YM0800XMental Health CounselorLPC-14213AZ

General Provider Information

NPI Number : 1467778621
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATRINA J BREWER LPC
Provider Business Mailing Address
First Line : 4414 N 19TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-4114
Country : US
Telephone Number : 602-285-5550
Fax Number : 480-223-6385
Provider Business Practice Location Address
First Line : 4414 N 19TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-4114
Country : US
Telephone Number : 602-285-5550
Fax Number : 480-223-6385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2010
Last Update Date : 07/15/2013

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