Provider Demographics
NPI:1053852533
Name:YORK, BREEANNE
Entity Type:Individual
Prefix:MRS
First Name:BREEANNE
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 JEFFERSON AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-6955
Mailing Address - Country:US
Mailing Address - Phone:419-335-3732
Mailing Address - Fax:
Practice Address - Street 1:701 JEFFERSON AVE
Practice Address - Street 2:STE 301
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-6955
Practice Address - Country:US
Practice Address - Phone:419-244-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker