Individual
MS. SUSAN S. BREAZEALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
C-04744
NM
104100000X
Social Worker
Primary
I-04744
NM
Other
Enumeration date
10/12/2006
Last updated
01/16/2020
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