Provider Demographics
NPI:1679291173
Name:BREIDENBACH, CARLEE
Entity type:Individual
Prefix:
First Name:CARLEE
Middle Name:
Last Name:BREIDENBACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 3RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2860
Mailing Address - Country:US
Mailing Address - Phone:541-990-3544
Mailing Address - Fax:833-770-4969
Practice Address - Street 1:433 3RD AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2860
Practice Address - Country:US
Practice Address - Phone:541-990-3544
Practice Address - Fax:833-770-4969
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor