Individual
MRS. BREANNE TERESA PASSALACQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,LPC
Contact information
Practice address
10291 FOLEY RD, FENTON, MI 48430-9250
(810) 597-7293
Mailing address
10291 FOLEY RD, FENTON, MI 48430-9250
(810) 597-7293
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401225133
MI
171M00000X
Case Manager/Care Coordinator
Primary
6301016145
MI
Other
Enumeration date
01/07/2015
Last updated
02/15/2026
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