Provider Demographics
NPI:1316013089
Name:BROWER-MIX, LIA CATHERINE (MS)
Entity Type:Individual
Prefix:
First Name:LIA
Middle Name:CATHERINE
Last Name:BROWER-MIX
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LIA
Other - Middle Name:CATHERINE BROWER
Other - Last Name:MIX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:531 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7609
Mailing Address - Country:US
Mailing Address - Phone:619-233-3432
Mailing Address - Fax:
Practice Address - Street 1:531 16TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-7609
Practice Address - Country:US
Practice Address - Phone:619-233-3432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health