# BREAK REPAIR HEAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972297414
- **Authorized official:** DANIELLE WRENCHER (CEO)
- **Authorized official phone:** (850) 634-8465

## Contact information

- **Practice address:** 501 EISENHOWER DR, CRESTVIEW, FL 32539-6955
- **Practice address phone:** (850) 634-8465
- **Mailing address:** 2821 S FERDON BLVD \# 1010, CRESTVIEW, FL 32536-8474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 06/07/2023
- **Last updated:** 06/22/2023