Individual
ELLYN BREESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
252 BROAD ST STE 6, RED BANK, NJ 07701-2012
(732) 252-7314
Mailing address
252 BROAD ST STE 6, RED BANK, NJ 07701-2012
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37AC00694100
NJ
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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