Provider Demographics
NPI:1114767878
Name:BREWER, ALEXIS PAYTON (RBT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:PAYTON
Last Name:BREWER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28286 BOERNE STAGE RD # 3
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-8404
Mailing Address - Country:US
Mailing Address - Phone:830-816-5510
Mailing Address - Fax:
Practice Address - Street 1:28286 BOERNE STAGE RD # 3
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-8404
Practice Address - Country:US
Practice Address - Phone:830-816-5510
Practice Address - Fax:855-421-1717
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-24-7149-744618106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician