Individual
DR. NICHOLAS J.K. BREITBORDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1670 UPHAM DR FL 3, COLUMBUS, OH 43210-1250
(614) 293-9600
(614) 366-1215
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-9600
(614) 366-1215
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P.7267
OH
103TF0000X
Family Psychologist
4063
AZ
103TF0000X
Family Psychologist
Primary
7267
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0132375
—
OH
Enumeration date
10/15/2009
Last updated
05/05/2026
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