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CHARLA MARIE BREITIGAM
>> Speech-Language Pathologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1528676756
Individual Registrant: CHARLA MARIE BREITIGAM
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
370 NE WILLIAMS AVE DEPOE BAY, OR 97341-1982 US
Tel: 760-382-0437 Fax: --
Tel: 760-382-0437 Fax: --
Contact information for business:
PO BOX 1138 DEPOE BAY, OR 97341-1138 US
Tel: 760-382-0437 Fax: --
Tel: 760-382-0437 Fax: --
Registration Information:
NPI: 1528676756
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | CA | 26501 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
