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NPI Code Detail

MEDICARE: ASHLEY BREWER MS

MEDICARE: ASHLEY BREWER MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1063998458
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY BREWER MS
Provider Business Mailing Address
First Line : 2440 SANDY PLAINS RD BLDG 25
Second Line :
City : MARIETTA
State : GA
Zip : 30066-7232
Country : US
Telephone Number : 770-971-9311
Fax Number :
Provider Business Practice Location Address
First Line : 2440 SANDY PLAINS RD BLDG 25
Second Line :
City : MARIETTA
State : GA
Zip : 30066-7232
Country : US
Telephone Number : 770-971-9311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2018
Last Update Date : 07/18/2018

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Directions to “ ASHLEY BREWER MS” Practice Location

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