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General NPI Number Information
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NPI Number | 1154970333
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Entity Type | Individual
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Provider Name | OLIVIA GRACE BROWER LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 1785 W STADIUM BLVD
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City | ANN ARBOR
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State | MI
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Zip | 48103-5285
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Country | US
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Telephone | 734-913-1093
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Fax |
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Provider Business Mailing Address
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Address Line | 4215 STRATHMORE LN
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City | CANTON
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State | MI
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Zip | 48188-7217
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Country | US
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Telephone | 616-862-7736
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801105666
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License Number State | MI
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