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General NPI Number Information
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NPI Number | 1639345903
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Entity Type | Individual
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Provider Name | AMY ELIZABETH BREHM LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 110 24TH ST S
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-1906
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Country | US
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Telephone | 715-323-3199
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Fax | 715-424-5720
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Provider Business Mailing Address
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Address Line | 203 UNITED WAY
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City | FREDERIC
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State | WI
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Zip | 54837-8938
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Country | US
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Telephone | 715-327-4402
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Fax | 715-327-8509
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 715-124
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License Number State | WI
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