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General NPI Number Information
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NPI Number | 1922343730
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Entity Type | Organization
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Legal Business Name | DAYBREAK FAMILY COUNSELING ENTERPRISES INCORPORATED
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 4405 W RIVERSIDE DR SUITE 203
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City | BURBANK
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State | CA
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Zip | 91505-4072
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Country | US
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Telephone | 818-238-9895
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Fax | 818-238-9896
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Provider Business Mailing Address
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Address Line | 4405 W RIVERSIDE DR SUITE 203
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City | BURBANK
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State | CA
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Zip | 91505-4072
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Country | US
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Telephone | 818-238-9895
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Fax | 818-238-9896
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | SUZETTE LORRAINE BRAY
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Credential | MFT
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Telephone | 818-238-9895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFC37518
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License Number State | CA
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