Provider Demographics
NPI:1174291215
Name:REBECCA BREIHOLZ PHD LLC
Entity type:Organization
Organization Name:REBECCA BREIHOLZ PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREIHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:541-890-5606
Mailing Address - Street 1:208 OAK ST STE 303
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1872
Mailing Address - Country:US
Mailing Address - Phone:541-890-5606
Mailing Address - Fax:
Practice Address - Street 1:208 OAK ST STE 303
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1872
Practice Address - Country:US
Practice Address - Phone:541-890-5606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)