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NPI Code Detail

MEDICARE: BRANDI BREWSTER

MEDICARE: BRANDI BREWSTER
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
1106S00000XBehavior Technician
2106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1538760764
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI BREWSTER
Provider Business Mailing Address
First Line : 5301 LEAWOOD
Second Line :
City : PINE BLUFF
State : AR
Zip : 71603-3539
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1525 MERRILL DR STE 100
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-1665
Country : US
Telephone Number : 501-228-0063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2020
Last Update Date : 11/04/2020

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Directions to “ BRANDI BREWSTER ” Practice Location

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