Provider Information for 1518284801
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Mr. JYE L. BRECKENRIDGE MSW, LISW-S
Sex: Male
NPI: 1518284801
Last Updated: 2013-05-11
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1518284801 | ||||||||
| Enumeration Date | 2010-04-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3400 N HIGH ST SUITE 120 COLUMBUS, OH 43202-1142 United States Phone: 614-282-1818 | Fax:614-358-0218 | ||||||||
| Primary Practice Address | 3400 N HIGH ST SUITE 120 COLUMBUS, OH 43202-1142 United States Phone: 614-282-1818 | Fax:614-358-0218 | ||||||||
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