Provider Demographics
NPI:1093445876
Name:BRETZ, HANNAH MARIE (LCPC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:BRETZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59771-0062
Mailing Address - Country:US
Mailing Address - Phone:303-502-6771
Mailing Address - Fax:
Practice Address - Street 1:766 PROFESSIONAL DR APT 3C
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-4130
Practice Address - Country:US
Practice Address - Phone:303-502-6771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-64571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health