Healthcare Provider Details

I. General information

NPI: 1568396950
Provider Name (Legal Business Name): MIAMI VALLEY PSYCHIATRIC HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S TIPPECANOE DR UNIT 3
TIPP CITY OH
45371-1194
US

IV. Provider business mailing address

115 S TIPPECANOE DR UNIT 3
TIPP CITY OH
45371-1194
US

V. Phone/Fax

Practice location:
  • Phone: 937-789-8546
  • Fax:
Mailing address:
  • Phone: 937-789-8546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER JULIA BREWER
Title or Position: OWNER
Credential: APRN
Phone: 937-789-8546