Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 2572 |
NPI | 1265959696 |
---|---|
Provider Name | Dr. Craig Alexander Brewick |
First Address | Folsom, CA 95630-1856 |
Second Address | Citrus Heights, CA 95621-1911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2017 |
Last Update Date | 25/08/2017 |