Provider Demographics
NPI:1659070092
Name:BROWER, TUESDAY D
Entity Type:Individual
Prefix:
First Name:TUESDAY
Middle Name:D
Last Name:BROWER
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:PO BOX 827
Mailing Address - Street 2:
Mailing Address - City:WINTON
Mailing Address - State:CA
Mailing Address - Zip Code:95388-0827
Mailing Address - Country:US
Mailing Address - Phone:209-621-9168
Mailing Address - Fax:
Practice Address - Street 1:6874 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:WINTON
Practice Address - State:CA
Practice Address - Zip Code:95388-9538
Practice Address - Country:US
Practice Address - Phone:209-621-9168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst