Individual
MS. KAITLYN MARIE BREAZEALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2011 ROAD 76, PASCO, WA 99301-1871
(509) 492-8883
Mailing address
2011 ROAD 76, PASCO, WA 99301-1871
(509) 492-8883
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SP60602011
WA
235Z00000X
Speech-Language Pathologist
Primary
60933272
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60933272
—
WA
Enumeration date
02/02/2016
Last updated
02/27/2019
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