MEDICARE: MRS. MARTHANNE MYERS BREWER LPC

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
1	101Y00000X	Counselor	2229	AL

General Provider Information

NPI Number	:	1376610683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHANNE MYERS BREWER LPC

Provider Business Mailing Address
First Line	:	9402 CHAMBERLAIN LN
Second Line	:
City	:	DAPHNE
State	:	AL
Zip	:	36526-6024
Country	:	US
Telephone Number	:	251-422-8326
Fax Number	:	251-621-2344

Provider Business Practice Location Address
First Line	:	1111 E I65 SERVICE RD S
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36606-3112
Country	:	US
Telephone Number	:	251-422-8326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	07/08/2007

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