Organization
IMAGINE A PATH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA RENEE BREITENBUCHER LPC (OWNER/PSYCHOTHERAPIST)
(541) 905-0500
Entity
Organization
Contact information
Practice address
2545 NE COMMUNITY LN, BEND, OR 97701-6628
(541) 905-0500
Mailing address
2545 NE COMMUNITY LN, BEND, OR 97701-6628
(541) 905-0500
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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