Individual
MRS. LILLIAN NICOLE BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4130 FOX BRUSH DR, EVANS, GA 30809-4856
(706) 825-9966
Mailing address
4130 FOX BRUSH DR, EVANS, GA 30809-4856
(706) 825-9966
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2631
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225X00000X
—
SC
Enumeration date
02/05/2009
Last updated
02/05/2009
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