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General NPI Number Information
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NPI Number | 1881362499
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Entity Type | Individual
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Provider Name | JORDAN BREWER LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 13680 HIGHWAY 9 N STE 500
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City | MILTON
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State | GA
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Zip | 30004-5170
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Country | US
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Telephone | 818-434-8921
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Fax |
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Provider Business Mailing Address
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Address Line | 92 W PACES FERRY RD NW UNIT 7012
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City | ATLANTA
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State | GA
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Zip | 30305-1470
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Country | US
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Telephone | 818-434-8921
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | MSW007670
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License Number State | GA
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