Individual
MS. MONTA ANNETTE BREEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LMT
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
(270) 798-8224
Mailing address
7024 RHODES AVENUE, ST. LOUIS, MO 63123
(615) 239-9562
(270) 798-8224
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
KY-3190
KY
104100000X
Social Worker
Primary
005085
MO
104100000X
Social Worker
KY-3190
KY
225700000X
Massage Therapist
2022049235
MO
Other
Enumeration date
10/30/2009
Last updated
09/27/2024
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