Provider Demographics
NPI:1952845265
Name:BREWER, HOLLY
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:BREWER
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 1:2945 BELL RD
Mailing Address - Street 2:#215
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2540
Mailing Address - Country:US
Mailing Address - Phone:916-765-1737
Mailing Address - Fax:530-888-0885
Practice Address - Street 1:2945 BELL RD
Practice Address - Street 2:#215
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2540
Practice Address - Country:US
Practice Address - Phone:916-765-1737
Practice Address - Fax:530-888-0885
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23391235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist