Individual
JACQUELINE BREAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A L.B.S
Contact information
Practice address
409 CHELSEA RD, FAIRLESS HILLS, PA 19030-2305
(267) 679-5968
Mailing address
409 CHELSEA RD, FAIRLESS HILLS, PA 19030-2305
(267) 679-5968
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH002497
PA
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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