Provider Demographics
NPI:1255690582
Name:BREWSTER, KAMALIHA (BA)
Entity Type:Individual
Prefix:MS
First Name:KAMALIHA
Middle Name:
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 LOS FELIZ ST UNIT 2051
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-8025
Mailing Address - Country:US
Mailing Address - Phone:702-494-9126
Mailing Address - Fax:
Practice Address - Street 1:4248 THOMAS PATRICK AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8941
Practice Address - Country:US
Practice Address - Phone:702-287-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner