Breault, Candace T
Breault, Candace T is an individual health care provider with primary practice located at 2500 Hall Ave Marinette County Health And Human Services Ste A, Marinette WI 54143. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Breault, Candace T can be contacted via phone (715) 732-7760.Contact Information
Primary practice address
2500 Hall Ave Marinette County Health And Human Services Ste A
Marinette WI 54143
Phone: (715) 732-7760
Fax: (715) 732-7711
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 3346123 | Wisconsin |
Profile Details
| NPI number | 1699864918 |
|---|---|
| LBN Legal business name | Breault, Candace T |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Feb 1st, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699864918 | NPPES |
| Wisconsin | Other | 3346123 | LICENSE |
| Wisconsin | MEDICAID | 39638400 | LICENSE |
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