Provider Demographics
NPI:1427089184
Name:BROUWERS, EMMELIEN (MPS)
Entity type:Individual
Prefix:
First Name:EMMELIEN
Middle Name:
Last Name:BROUWERS
Suffix:
Gender:F
Credentials:MPS
Other - Prefix:
Other - First Name:EMMELIEN
Other - Middle Name:
Other - Last Name:BROUWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 GREAT JONES ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1140
Mailing Address - Country:US
Mailing Address - Phone:212-979-0765
Mailing Address - Fax:212-979-0765
Practice Address - Street 1:55 GREAT JONES ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1140
Practice Address - Country:US
Practice Address - Phone:212-597-9076
Practice Address - Fax:212-979-0765
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLP560103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis