Individual
STEPHANIE THERESE BREITENSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
4310 W CLARK ST, BOISE, ID 83705-2024
(928) 853-5475
Mailing address
PO BOX 8553, BOISE, ID 83707-2553
(208) 495-4147
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-6978
ID
101YP2500X
Professional Counselor
LPC-16079
AZ
Other
Enumeration date
07/25/2019
Last updated
02/05/2021
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