Provider Demographics
NPI:1871061705
Name:BREWER, RHONDA MARIE (MA)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:MARIE
Last Name:BREWER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:MARIE
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:624 W HASTINGS RD STE 9
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2877
Mailing Address - Country:US
Mailing Address - Phone:509-599-5572
Mailing Address - Fax:
Practice Address - Street 1:624 W HASTINGS RD STE 9
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2877
Practice Address - Country:US
Practice Address - Phone:509-599-5572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60765335101YM0800X, 101Y00000X
WAMG60765461106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist