Individual
BRUCE RAY BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
22 WEST FIRECLAY AVE, SUITE C-105, MURRY, UT 84107-2637
(801) 266-1499
Mailing address
3823 PEBBLE LN, PROVO, UT 84604-5268
(801) 371-0388
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
319691-2504
UT
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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