MEDICARE: RAMONA BREWER

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	1041C0700X	Clinical Social Worker
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1992961015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMONA BREWER

Provider Business Mailing Address
First Line	:	3026 BARDSTOWN RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3020
Country	:	US
Telephone Number	:	502-915-0012
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 BRECKENRIDGE LN STE 1D
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-2793
Country	:	US
Telephone Number	:	502-915-0012
Fax Number	:	502-589-8771

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

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	10/20/2022

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Directions to “ RAMONA BREWER ” Practice Location

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