| Doctor Name: | MS. BONNIE AYER BREIDENBACH |
| NPI Number: | 1275558264 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | CNS 6401005658 |
| Business Practice Address: | 24715 Little Mack Ave St Clair Shores, MI - 480803207 |
| Business Phone Number: | 5867779000 |
| Business Fax Number: | 5867770823 |
| Mailing Address: | 1313 Woodbridge St, ST CLAIR SHORES |
| State: | MI |
| Postal Code: | 48080 |
| Phone Number: | 5867793862 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | CNS 6401005658 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |