Individual
JENNIFER MAE LAVENE BREITENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
15221 STATE ROUTE 772, PIKETON, OH 45661-9062
(740) 493-4260
(740) 493-4262
Mailing address
PO BOX 226, WAVERLY, OH 45690-0226
(740) 493-4260
(740) 493-4262
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
162885
OH
Other
Enumeration date
10/25/2017
Last updated
10/25/2017
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