Individual
KELSEY LYNN BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 BOGACHIEL WAY, FORKS, WA 98331-9120
(360) 374-5011
Mailing address
530 BOGACHIEL WAY, FORKS, WA 98331-9120
(360) 374-5011
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61552805
WA
Other
Enumeration date
03/04/2024
Last updated
05/21/2024
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