Provider Demographics
NPI:1831725498
Name:BREWER, ALEX (SCHOOL PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:BREWER
Suffix:
Gender:M
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 N MERIDIAN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SUNMAN
Mailing Address - State:IN
Mailing Address - Zip Code:47041-7771
Mailing Address - Country:US
Mailing Address - Phone:812-623-2212
Mailing Address - Fax:
Practice Address - Street 1:925 N MERIDIAN ST STE 100
Practice Address - Street 2:
Practice Address - City:SUNMAN
Practice Address - State:IN
Practice Address - Zip Code:47041-7771
Practice Address - Country:US
Practice Address - Phone:812-623-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1407729103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool