Provider Demographics
NPI:1245594720
Name:BREEN, DEBBIE ANN
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:ANN
Last Name:BREEN
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 1:1214 BRIGHTMOOR DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-8817
Mailing Address - Country:US
Mailing Address - Phone:704-807-6555
Mailing Address - Fax:
Practice Address - Street 1:1214 BRIGHTMOOR DR
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-8817
Practice Address - Country:US
Practice Address - Phone:704-807-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional