Organization
BREAKING CHAINS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORRINA BRANDSTETTER PSYD (OWNER)
(503) 964-7642
Entity
Organization
Contact information
Practice address
710C E FOOTHILLS DR., SUITE 103, NEWBERG, OR 97132-6125
(503) 964-7642
Mailing address
710C E FOOTHILLS DR., SUITE 103, NEWBERG, OR 97132-6125
(503) 964-7642
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1880
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376735027
PROVIDER NPI
OR
Enumeration date
08/31/2016
Last updated
08/31/2016
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