Individual
DAVID LEE BREAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1005 S WASHINGTON ST, BAINBRIDGE, GA 39819-4465
(229) 248-2683
Mailing address
1005 S WASHINGTON ST, BAINBRIDGE, GA 39819-4465
(229) 248-2683
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
007527
GA
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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