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NPI 1568698801

NPI 1568698801 : PENNY ANDERSON-BRESLIN MA, NCC, NCLPC : OAKBORO, NC

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General NPI Number Information
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    NPI Number           |    1568698801
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    Entity Type          |    Individual 
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    Provider Name        |    PENNY ANDERSON-BRESLIN MA, NCC, NCLPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/01/2009
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    Last Update Date     |    06/01/2009
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Provider Practice Location Address
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    Address Line         |    306 E RED CROSS RD 
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    City                 |    OAKBORO
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    State                |    NC
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    Zip                  |    28129-7202
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    Country              |    US
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    Telephone            |    704-485-3012
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    306 E RED CROSS RD 
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    City                 |    OAKBORO
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    State                |    NC
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    Zip                  |    28129-7202
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    Country              |    US
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    Telephone            |    704-485-3012
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    6711
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    License Number State |    NC
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