Provider Demographics
NPI:1558761338
Name:BREWTON, ALANNA
Entity Type:Individual
Prefix:
First Name:ALANNA
Middle Name:
Last Name:BREWTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 LYNDHURST AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5104
Mailing Address - Country:US
Mailing Address - Phone:704-446-0393
Mailing Address - Fax:704-348-4057
Practice Address - Street 1:1816 LYNDHURST AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5104
Practice Address - Country:US
Practice Address - Phone:704-446-0393
Practice Address - Fax:704-348-4057
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3298101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)