Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor |
NPI | 1114078565 |
---|---|
Provider Name | Lynne Silva-Breen |
First Address | Burnsville, MN 55337-4432 |
Second Address | Burnsville, MN 55337-4432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2007 |
Last Update Date | 03/06/2009 |