Individual
MRS. JACKIE LYNNE BREUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMF
Contact information
Practice address
7747 MITCHELL BLVD STE B, TRINITY, FL 34655-4725
(661) 433-6382
Mailing address
7747 MITCHELL BLVD STE B, TRINITY, FL 34655-4725
(661) 433-6382
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
MFC46070
CA
106H00000X
Marriage & Family Therapist
Primary
MT2656
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00007473
—
CA
01
—
CBSC144
LA DMH PROVIDER
CA
Enumeration date
04/10/2007
Last updated
11/03/2020
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