Individual
KATHLEEN BREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 799-3175
Mailing address
30 WILDBROOK DR, RUTLAND, MA 01543-1266
(508) 886-4954
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6036
MA
103T00000X
Psychologist
Primary
884
MA
103TS0200X
School Psychologist
274592
MA
1041S0200X
School Social Worker
274592
MA
Other
Enumeration date
04/20/2007
Last updated
09/11/2025
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