Provider Demographics
NPI:1760130967
Name:BROWER, DIANNE ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:ELIZABETH
Last Name:BROWER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 W BROAD ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-1824
Mailing Address - Country:US
Mailing Address - Phone:860-333-7800
Mailing Address - Fax:
Practice Address - Street 1:155 W BROAD ST APT 1
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-1824
Practice Address - Country:US
Practice Address - Phone:860-333-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT03-918691101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional