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General NPI Number Information
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NPI Number | 1720367691
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Entity Type | Individual
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Provider Name | SUSAN DENISE BREWER MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 535 N DOUGLAS AVE HILLCREST
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City | LOVELAND
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State | CO
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Zip | 80537
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Country | US
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Telephone | 970-593-9800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 273173
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City | FT COLLINS
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State | CO
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Zip | 80527
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Country | US
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Telephone | 970-420-2908
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 12092423ASHA
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License Number State |
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