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General NPI Number Information
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NPI Number | 1659016541
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Entity Type | Individual
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Provider Name | BREANNA REED
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Gender | Female
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 14050 NICOLLET AVE STE 301B
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City | BURNSVILLE
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State | MN
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Zip | 55337-5739
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Country | US
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Telephone | 651-230-0270
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Fax |
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Provider Business Mailing Address
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Address Line | 18325 ELKWOOD AVE
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City | FARMINGTON
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State | MN
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Zip | 55024-8702
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Country | US
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Telephone | 651-230-0270
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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 | 3314
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License Number State | MN
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