| Breakaway Mental Health, Pllc | |
|
116 W 7th Ave Ste 324 Stillwater OK 74074-4018 | |
| (405) 385-4225 | |
| Not Available |
| Full Name | Breakaway Mental Health, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 116 W 7th Ave Ste 324, Stillwater, Oklahoma |
| Authorized Official Name and Position | Becky Diane Aebi (OWNER/CEO) |
| Authorized Official Contact | 4053854225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakaway Mental Health, Pllc 116 W 7th Ave Ste 324 Stillwater OK 74074-4018 Ph: (405) 385-4225 | Breakaway Mental Health, Pllc 116 W 7th Ave Ste 324 Stillwater OK 74074-4018 Ph: (405) 385-4225 |
| NPI Number | 1235969007 |
|---|---|
| Provider Enumeration Date | 08/06/2024 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235969007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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