Provider Demographics
NPI:1275342693
Name:BREITENBACH, BARBARA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BREITENBACH
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 1:191 NW 118TH DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8001 SW 36TH ST STE 9
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1915
Practice Address - Country:US
Practice Address - Phone:954-577-7790
Practice Address - Fax:954-577-7780
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician