Breckow, Jacqulyn
Breckow, Jacqulyn is an sole proprietor health care provider with primary practice located at 690 E Warner Rd Suite #105, Gilbert AZ 85296-3054. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Breckow, Jacqulyn can be contacted via phone (480) 820-6366.Contact Information
Primary practice address
690 E Warner Rd Suite #105
Gilbert AZ 85296-3054
Phone: (480) 820-6366
Fax: (480) 820-0462
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | TSLP4726 | Arizona |
Profile Details
| NPI number | 1689737421 |
|---|---|
| LBN Legal business name | Breckow, Jacqulyn |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Dec 18th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689737421 | NPPES |
| Arizona | MEDICAID | 948317 |
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