Provider Demographics
NPI:1205446630
Name:BREWER, EMILY ANN (PHD, LP, LSSP)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ANN
Last Name:BREWER
Suffix:
Gender:F
Credentials:PHD, LP, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BRIARCREST DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2529
Mailing Address - Country:US
Mailing Address - Phone:979-229-7636
Mailing Address - Fax:
Practice Address - Street 1:1100 BRIARCREST DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2529
Practice Address - Country:US
Practice Address - Phone:979-229-7636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71324103TS0200X
TX38652103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool