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General NPI Number Information
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NPI Number | 1912453168
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Entity Type | Individual
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Provider Name | SHARON BREEDEN PLPC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 330 N GORE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63119-1600
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Country | US
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Telephone | 314-795-8683
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Fax |
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Provider Business Mailing Address
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Address Line | 1175 MILL CROSSING DR APT 306
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City | CREVE COEUR
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State | MO
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Zip | 63141-6192
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Country | US
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Telephone | 314-795-8683
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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 | 2016010263
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License Number State | MO
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