Individual
SUSAN J LOLLIS-BREEDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LADC/MH
Contact information
Practice address
1737 LINWOOD BLVD, OKLAHOMA CITY, OK 73106-5037
(405) 239-6815
(405) 239-2637
Mailing address
14625 NE 23RD ST, CHOCTAW, OK 73020-8728
(405) 390-8131
(405) 835-2253
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1434
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
04/01/2015
Last updated
11/22/2022
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