Provider Demographics
NPI:1447418488
Name:BROWER, KRISTI L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:L
Last Name:BROWER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-0276
Mailing Address - Country:US
Mailing Address - Phone:815-758-8400
Mailing Address - Fax:815-758-8441
Practice Address - Street 1:1625 BETHANY RD
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3124
Practice Address - Country:US
Practice Address - Phone:779-777-7335
Practice Address - Fax:815-758-8440
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007452103T00000X, 103TC0700X
071.007452103TB0200X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth