Individual
MICKEY BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 N 70TH AVE, OMAHA, NE 68104-4620
(402) 812-5163
Mailing address
4020 N 43RD ST, OMAHA, NE 68111-2514
(402) 812-5163
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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