Individual
MS. CAROL MARQUIS BRECKENRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3505 WESTERN AVE, KINGMAN, AZ 86409-3011
(928) 757-8111
(928) 757-1192
Mailing address
3505 WESTERN AVE, KINGMAN, AZ 86409-3011
(928) 757-8111
(928) 757-1192
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10684
AZ
Other
Enumeration date
02/11/2013
Last updated
02/11/2013
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