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Individual
KELLAND JAY BREWER
Active
Individual
KELLAND JAY BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10834446-3502
UT
1041C0700X
Clinical Social Worker
Primary
10834446-3501
UT
Other
Enumeration date
07/31/2018
Last updated
08/18/2022
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