Individual
RICHARD LYNN BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
315 S MAIN AVE, BOLIVAR, MO 65613-2052
(417) 326-2902
(417) 326-4555
Mailing address
PO BOX 100, PIERCE CITY, MO 65723-2100
(417) 476-1013
(417) 476-1082
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01577
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2970
BLUE CROSS BLUE SHIELD
MO
05
—
496642505
—
MO
Enumeration date
01/25/2006
Last updated
09/17/2015
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