Individual
MARY BREITENBUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
120 LABREE AVE S, THIEF RIVER FALLS, MN 56701-2840
(218) 683-4351
(218) 683-4362
Mailing address
120 LABREE AVE S, THIEF RIVER FALLS, MN 56701-2840
(218) 683-4351
(218) 683-4362
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0394
MN
Other
Enumeration date
01/13/2009
Last updated
01/13/2009
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