Individual
JACLYN BROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
845 S CRISMON RD, MESA, AZ 85208-2564
(480) 472-9400
Mailing address
17100 E SHEA BLVD STE 600, FOUNTAIN HILLS, AZ 85268-6663
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP10555
AZ
235Z00000X
Speech-Language Pathologist
SP25120
CA
Other
Enumeration date
06/11/2017
Last updated
07/21/2022
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