Wymeka Andrea Breaux, B.S
Case Manager/Care Coordinator in Ruston, LA. Individual provider (NPI-1).
NPI number1861975237
StatusActive
Last updated in NPPESJun 13, 2023
Details
- NPI
- 1861975237
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Wymeka Andrea Breaux
- Credential
- B.S
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 12, 2018
- Certification date
- Jun 13, 2023
- Last updated
- Jun 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
705 Martin Luther King Dr.Ruston, LA 71270
Phone 832-450-8008
Mailing address
705 Martin Luther King Dr.Ruston, LA 71270
Phone 832-450-8008
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