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NPI Code Detail

MEDICARE: BREETA GARLAND CCC-SLP

MEDICARE: BREETA GARLAND CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP2043AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0140920OTHERAZBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700912391
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREETA GARLAND CCC-SLP
Provider Business Mailing Address
First Line : 108 W UNIVERSITY DR
Second Line :
City : MESA
State : AZ
Zip : 85201-5818
Country : US
Telephone Number : 480-668-2750
Fax Number : 480-668-1917
Provider Business Practice Location Address
First Line : 108 W UNIVERSITY DR
Second Line :
City : MESA
State : AZ
Zip : 85201-5818
Country : US
Telephone Number : 480-668-2750
Fax Number : 480-668-1917
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 03/25/2025

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Directions to “ BREETA GARLAND CCC-SLP” Practice Location

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