Provider Demographics
NPI:1114112109
Name:BREWER, PAULA MARIE (MS, LMFT, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:MARIE
Last Name:BREWER
Suffix:
Gender:F
Credentials:MS, LMFT, LPC, NCC
Other - Prefix:MISS
Other - First Name:PAULA
Other - Middle Name:MARIE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT, LPC, NCC
Mailing Address - Street 1:4133 BLOSSOM LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6996
Mailing Address - Country:US
Mailing Address - Phone:507-990-3065
Mailing Address - Fax:
Practice Address - Street 1:1110 6TH ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1839
Practice Address - Country:US
Practice Address - Phone:507-287-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00505101YP2500X
MN1613106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional