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General NPI Number Information
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NPI Number | 1619631082
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Entity Type | Individual
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Provider Name | WENDY BREEN LISW-S
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Gender | Female
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 1855 E DUBLIN GRANVILLE RD STE 204
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City | COLUMBUS
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State | OH
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Zip | 43229-3516
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Country | US
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Telephone | 614-267-7003
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Fax |
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Provider Business Mailing Address
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Address Line | 4690 DONEGAL CLIFFS DR
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City | DUBLIN
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State | OH
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Zip | 43017-8659
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Country | US
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Telephone | 614-746-1288
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | I.0008554
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License Number State | OH
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