Individual
ELLERY BREWBAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7806 E 108TH ST STE A, TULSA, OK 74133-7414
(918) 296-7746
Mailing address
7806 E 108TH ST STE A, TULSA, OK 74133-7414
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10003
OK
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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