Individual
KAMRY BOND BREAZEALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
688 ANTELOPE GAP RD, WHEATLAND, WY 82201-8810
(308) 631-6066
Mailing address
63 CALVIN PURVIS RD, PURVIS, MS 39475-4242
(601) 596-5755
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
BBH-PCLC-LIC-55453
MT
Other
Enumeration date
01/06/2023
Last updated
08/14/2023
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