Individual
MS. BREEANN NICOLE POULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
4100 NORMAL ST, SAN DIEGO, CA 92103-2653
(858) 490-8517
Mailing address
4100 NORMAL ST, SAN DIEGO, CA 92103-2653
(858) 490-8517
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
24456
CA
Other
Enumeration date
05/09/2018
Last updated
03/16/2026
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