Provider Demographics
NPI:1700890910
Name:BREWER, LIA HARPER (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LIA
Middle Name:HARPER
Last Name:BREWER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 SORENSEN DR
Mailing Address - Street 2:
Mailing Address - City:KEMMERER
Mailing Address - State:WY
Mailing Address - Zip Code:83101-3450
Mailing Address - Country:US
Mailing Address - Phone:307-877-3446
Mailing Address - Fax:307-877-3446
Practice Address - Street 1:1328 SORENSEN DR
Practice Address - Street 2:
Practice Address - City:KEMMERER
Practice Address - State:WY
Practice Address - Zip Code:83101-3450
Practice Address - Country:US
Practice Address - Phone:307-877-3446
Practice Address - Fax:307-877-3446
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLMFT-122106H00000X
CAMFT27710106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist