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Individual
RENE D BREEDLOVE
Active
Individual
RENE D BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-02-03
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500696824
—
OR
Enumeration date
08/14/2015
Last updated
08/31/2017
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