Individual
VIRGINIA BREEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
130 DIVISION STREET, GRIFFIN HOSPITAL, DERBY, CT 06418
(203) 732-7550
(203) 732-1550
Mailing address
130 DIVISION STREET, GRIFFIN HOSPITAL, DERBY, CT 06418
(203) 732-7550
(203) 732-1550
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000614
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000471
LICENSE
CT
Enumeration date
09/04/2008
Last updated
09/04/2008
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