Provider Demographics
NPI:1093241853
Name:BRESLIN, JENNIFER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:BRESLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W SIXTH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2428
Mailing Address - Country:US
Mailing Address - Phone:484-445-4147
Mailing Address - Fax:484-445-4149
Practice Address - Street 1:100 W SIXTH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2428
Practice Address - Country:US
Practice Address - Phone:484-445-4147
Practice Address - Fax:484-445-4149
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018280103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist