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1811614803
IAN THOMSON BRECKENRIDGE
WENTZVILLE, MO
NPI
1811614803
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MO 2017044140)
Enumeration Date
2022-10-20
Last Update Date
2022-10-20
Business Address
Mr. IAN THOMSON BRECKENRIDGE LPC
1642 WOODS MILL DR
WENTZVILLE, MO 63385-2629
Phone number: 314-442-5320
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Mailing Address
Mr. IAN THOMSON BRECKENRIDGE LPC
1642 WOODS MILL DR
WENTZVILLE, MO 63385-2629
Phone number: 314-442-5320
Copy
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