Individual
DAVID JOSEPH BREAULT
Active
Individual
DAVID JOSEPH BREAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-2244
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NM00R39Q
BLUECROSSBLUESHIELD
NM
01
—
096959
VALUEOPTIONS
NM
01
—
260776
COMPSYCH
NM
05
—
97446
—
NM
01
—
NM100163
VALUEOPTIONS
NM
Enumeration date
01/10/2007
Last updated
07/09/2007
Update your record
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