Provider Demographics
NPI:1831521038
Name:BROWER, GRISELDA MARIA DEL CARMEN (AA)
Entity type:Individual
Prefix:
First Name:GRISELDA
Middle Name:MARIA DEL CARMEN
Last Name:BROWER
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SIERRA CIR
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4651
Mailing Address - Country:US
Mailing Address - Phone:307-689-8574
Mailing Address - Fax:
Practice Address - Street 1:116 SIERRA CIR
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4651
Practice Address - Country:US
Practice Address - Phone:307-689-8574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator