Provider Demographics
NPI:1316088446
Name:BRASHERS, EVELYN (CMT)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:BRASHERS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401216
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92340-1216
Mailing Address - Country:US
Mailing Address - Phone:760-953-0140
Mailing Address - Fax:760-956-1695
Practice Address - Street 1:21840 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-3916
Practice Address - Country:US
Practice Address - Phone:760-953-0140
Practice Address - Fax:760-956-1695
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist