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General NPI Number Information
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NPI Number | 1750107173
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Entity Type | Individual
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Provider Name | KELLY BREWER LSW
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 3347 CORPORATE PARKWAY
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City | CENTER VALLEY
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State | PA
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Zip | 18034
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Country | US
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Telephone | 267-217-2068
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Fax |
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Provider Business Mailing Address
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Address Line | 909 WASHINGTON ST
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City | EASTON
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State | PA
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Zip | 18042-4341
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW136603
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License Number State | PA
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