Individual
BREANE MIKAILA SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
188 W HEBBLE AVE, FAIRBORN, OH 45324-4960
(937) 754-5911
Mailing address
5300 SAUM ST, FAIRBORN, OH 45324-1821
(660) 624-9840
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/10/2025
Last updated
08/19/2025
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