Provider Demographics
NPI:1619406386
Name:BREWER, JOEL T (AUD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:T
Last Name:BREWER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5041
Mailing Address - Country:US
Mailing Address - Phone:605-336-3503
Mailing Address - Fax:605-336-6010
Practice Address - Street 1:2315 W 57TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5041
Practice Address - Country:US
Practice Address - Phone:605-336-3503
Practice Address - Fax:605-336-6010
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD461A237600000X
231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter