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General NPI Number Information
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NPI Number | 1669993424
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Entity Type | Individual
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Provider Name | BREE BRETON
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Gender | Female
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 278 TROGDON LN
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City | BEDFORD
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State | IN
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Zip | 47421-8652
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Country | US
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Telephone | 219-281-2279
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Fax |
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Provider Business Mailing Address
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Address Line | 4120 E RAMP CREEK RD
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City | BLOOMINGTON
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State | IN
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Zip | 47401-9547
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Country | US
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Telephone | 812-679-1783
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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