Individual
CANDACE T BREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2500 HALL AVE, MARINETTE COUNTY HEALTH AND HUMAN SERVICES STE A, MARINETTE, WI 54143
(715) 732-7760
(715) 732-7711
Mailing address
2500 HALL AVE, MARINETTE COUNTY HEALTH AND HUMAN SERVICES STE A, MARINETTE, WI 54143
(715) 732-7760
(715) 732-7711
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3346123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3346123
LICENSE
WI
05
—
39638400
—
WI
Enumeration date
10/12/2006
Last updated
02/01/2008
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