Healthcare Provider Details

I. General information

NPI: 1528897642
Provider Name (Legal Business Name): MOLLIE BREWER M.ED., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 CHANDLER RD
GREER SC
29651-1218
US

IV. Provider business mailing address

2431 LEGACY MAPLE DR
BRASELTON GA
30517-4096
US

V. Phone/Fax

Practice location:
  • Phone: 864-355-2400
  • Fax:
Mailing address:
  • Phone: 706-362-9499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202012355
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP013692
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.9775
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: