| Breakthrough Education Support | |
|
1260 Lake Blvd Wl-228 Davis CA 95616-2614 | |
| (530) 219-4309 | |
| Not Available |
| Full Name | Breakthrough Education Support |
|---|---|
| Speciality | Psychologist - School |
| Location | 1260 Lake Blvd, Davis, California |
| Authorized Official Name and Position | Rowan E Foley (OWNER) |
| Authorized Official Contact | 5302194309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Education Support 1260 Lake Blvd Davis CA 95616-2614 Ph: (530) 219-4309 | Breakthrough Education Support 1260 Lake Blvd Wl-228 Davis CA 95616-2614 Ph: (530) 219-4309 |
| NPI Number | 1447935895 |
|---|---|
| Provider Enumeration Date | 06/21/2023 |
| Last Update Date | 02/16/2024 |
| Certification Date | 02/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447935895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TS0200X | Psychologist - School | (* (Not Available)) | Primary |
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