Provider Demographics
NPI:1003587684
Name:HYZY, GREGORY (AMFT)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:HYZY
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:PRETZYL
Other - Middle Name:
Other - Last Name:HYZY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3301 CANDELARIA RD NE STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1965
Mailing Address - Country:US
Mailing Address - Phone:505-273-6300
Mailing Address - Fax:505-265-7860
Practice Address - Street 1:3301 CANDELARIA RD NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1965
Practice Address - Country:US
Practice Address - Phone:505-273-6300
Practice Address - Fax:505-265-7860
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMCTB-2022-0103106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program