Individual
JACLYN MARIE BRUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
7 SMITH AVE, GREENVILLE, RI 02828-1763
(401) 954-6040
Mailing address
99 INDIAN RUN TRL, SMITHFIELD, RI 02917-2134
(860) 608-0061
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
76502
MA
Other
Enumeration date
06/04/2017
Last updated
05/03/2023
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