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General NPI Number Information
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NPI Number | 1346179389
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Entity Type | Individual
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Provider Name | BREANNA NAKAMURA
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Gender | Female
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 11811 N TATUM BLVD STE 3031
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City | PHOENIX
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State | AZ
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Zip | 85028-1621
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Country | US
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Telephone | 602-456-2936
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Fax |
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Provider Business Mailing Address
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Address Line | 17910 E SANOQUE BLVD
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City | GILBERT
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State | AZ
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Zip | 85298-9220
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Country | US
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Telephone | 808-366-4035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA17234
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License Number State | AZ
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