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General NPI Number Information
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NPI Number | 1316733280
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Entity Type | Individual
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Provider Name | MADISON BREWER MS
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Gender | Female
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 3303 LEE PKWY STE 410
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City | DALLAS
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State | TX
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Zip | 75219-5116
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Country | US
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Telephone | 214-444-3649
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Fax |
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Provider Business Mailing Address
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Address Line | 8277 SOUTHWESTERN BLVD APT 2086
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City | DALLAS
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State | TX
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Zip | 75206-9329
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 97560
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License Number State | TX
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