Provider Demographics
NPI:1265771018
Name:BRESLIN, JENNIFER HECKMAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HECKMAN
Last Name:BRESLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6526
Mailing Address - Country:US
Mailing Address - Phone:520-795-7750
Mailing Address - Fax:520-320-2155
Practice Address - Street 1:502 N SILVERBELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2626
Practice Address - Country:US
Practice Address - Phone:520-882-5898
Practice Address - Fax:520-882-5899
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4369103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical