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CHARLA MARIE BREITIGAM

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1528676756

Individual Registrant:
 CHARLA MARIE BREITIGAM 
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: --

Contact information for business:
PO BOX 1138  DEPOE BAY, OR 97341-1138 US
Tel: 760-382-0437  Fax: --

Registration Information:
NPI: 1528676756
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
CA26501

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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