Individual
MICAH BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2488 GRAND CONCOURSE, BRONX, NY 10458-5203
(718) 584-7204
Mailing address
2488 GRAND CONCOURSE, BRONX, NY 10458-5203
(718) 584-7204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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