Individual
MS. CARRIE DALI BREAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2917 13TH ST W, APT/SUITE, LEHIGH ACRES, FL 33971-5403
(239) 851-9625
Mailing address
2917 13TH ST W, LEHIGH ACRES, FL 33971-5403
(239) 369-3988
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/01/2011
Last updated
07/08/2013
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