Provider Demographics
NPI:1396473328
Name:ARMIJO, BREANA (PPC)
Entity type:Individual
Prefix:MISS
First Name:BREANA
Middle Name:
Last Name:ARMIJO
Suffix:
Gender:F
Credentials:PPC
Other - Prefix:
Other - First Name:BREANA
Other - Middle Name:
Other - Last Name:ARMIJO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PPC
Mailing Address - Street 1:4025 RAWLINS ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1900
Mailing Address - Country:US
Mailing Address - Phone:307-222-3042
Mailing Address - Fax:
Practice Address - Street 1:123 W 1ST ST STE 705
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2488
Practice Address - Country:US
Practice Address - Phone:307-222-3042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health