Basic Information
Provider Information
NPI: 1811327687
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BREMER
FirstName: TAYLOR
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 325 SW FRAZIER AVE
Address2:  
City: TOPEKA
State: KS
PostalCode: 666061963
CountryCode: US
TelephoneNumber: 7852325005
FaxNumber: 7852320160
Practice Location
Address1: 325 SW FRAZIER AVE
Address2:  
City: TOPEKA
State: KS
PostalCode: 66606
CountryCode: US
TelephoneNumber: 7852325005
FaxNumber: 7852320160
Other Information
ProviderEnumerationDate: 11/15/2013
LastUpdateDate: 07/12/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X3208KSY Behavioral Health & Social Service ProvidersCounselorProfessional
172V00000X  N Other Service ProvidersCommunity Health Worker 

No ID Information.


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