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Individual

MRS. MARTHA BATES BREWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
492 RIDGEWOOD DR, DAPHNE, AL 36526-8030
(828) 279-6949
Mailing address
492 RIDGEWOOD DR, DAPHNE, AL 36526-8030
(828) 279-6949

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5260
AL
235Z00000X
Speech-Language Pathologist
S4265
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05850766
MS
Enumeration date
06/14/2011
Last updated
11/07/2023
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