Individual provider · Type 1 NPI
Gary J. Breault
Professional Counselor · Worcester, MA
NPI number
1104071315
Active
Practice location
25 Catharine St
Worcester, MA 01605-2709
Fax (508) 754-2971
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 6675 (MA) |
| School Counselor | 101YS0200X | 321767 (MA) |
Professional Counselor: Definition to come...
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About NPI 1104071315
Gary J. Breault's National Provider Identifier is 1104071315, issued on Dec 2, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Worcester, MA. The record was last updated on Dec 2, 2008.