Provider Demographics
NPI:1164738977
Name:BROUWER, KYLE
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:BROUWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 E CLARK ST
Mailing Address - Street 2:UNIVERSITY OF SOUTH DAKOTA, NOTEBOOM HALL
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-2307
Mailing Address - Country:US
Mailing Address - Phone:605-677-7255
Mailing Address - Fax:
Practice Address - Street 1:414 E CLARK ST
Practice Address - Street 2:UNIVERSITY OF SOUTH DAKOTA
Practice Address - City:VERMILLION
Practice Address - State:SD
Practice Address - Zip Code:57069-2307
Practice Address - Country:US
Practice Address - Phone:605-677-7255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist