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Individual

MRS. JACQUELINE DENISE BREWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW, CAC II

Contact information

Practice address
1061 HARMON AVE, STE 1D03, FORT STEWART, GA 31314-5674
(912) 767-5265
Mailing address
1061 HARMON AVE, STE 1D03, FORT STEWART, GA 31314-5674
(912) 767-5265

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1503
GA
104100000X
Social Worker
MSW003033
GA

Other

Enumeration date
08/17/2005
Last updated
05/03/2011
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