| Doctor Name: | MRS. JACQULYN BRECKOW |
| NPI Number: | 1689737421 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | TSLP4726 |
| Business Practice Address: | 690 E Warner Rd Suite #105 Gilbert, AZ - 852963054 |
| Business Phone Number: | 4808206366 |
| Business Fax Number: | 4808200462 |
| Mailing Address: | 690 E Warner Rd, Suite #105 GILBERT |
| State: | AZ |
| Postal Code: | 852963054 |
| Phone Number: | 4808206366 |
| Fax Number: | 4808200462 |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 12/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 06/18/2010 |
| NPI Reactivation Date: | 11/02/2012 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | TSLP4726 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |