Individual
STEPHANIE MARIE BREEDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Mailing address
3623 JANUARY AVE, SAINT LOUIS, MO 63109-1502
(423) 506-4353
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070023743
IL
225100000X
Physical Therapist
Primary
2019042348
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019042348
MISSOURI DIVISION OF PROFESSIONAL REGISTRATION
MO
Enumeration date
09/26/2022
Last updated
03/19/2024
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