Provider Demographics
NPI:1083337000
Name:PRETIGER, HOLLIE BREANNE
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:BREANNE
Last Name:PRETIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOLLIE
Other - Middle Name:BREANNE
Other - Last Name:PRETIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1104 HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-6450
Mailing Address - Country:US
Mailing Address - Phone:432-264-4228
Mailing Address - Fax:
Practice Address - Street 1:1104 HENDERSON ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-6450
Practice Address - Country:US
Practice Address - Phone:325-236-6821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118450235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist