| Doctor Name: | MARY J BREAULT |
| NPI Number: | 1750625729 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | H.I.S |
| License Number: | 1392-60 |
| Business Practice Address: | 131 Carmichael Rd Ste 205 Hudson, WI - 540168271 |
| Business Phone Number: | 7153811330 |
| Business Fax Number: | 7153811339 |
| Mailing Address: | 1802 Galloway St, EAU CLAIRE |
| State: | WI |
| Postal Code: | 547033467 |
| Phone Number: | 7158318966 |
| Fax Number: | 7158318968 |
| NPI Enumeration Date: | 11/15/2012 |
| NPI Last Update Date: | 11/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237700000X |
| License Number: | 1392-60 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Hearing Instrument Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |