Provider Demographics
NPI:1164745311
Name:BRETZ, KAREN M (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:BRETZ
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 1:124 COUNTY LINE RD W
Mailing Address - Street 2:STE B
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7233
Mailing Address - Country:US
Mailing Address - Phone:614-360-2600
Mailing Address - Fax:844-320-2600
Practice Address - Street 1:124 COUNTY LINE RD W
Practice Address - Street 2:STE B
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7233
Practice Address - Country:US
Practice Address - Phone:614-360-2600
Practice Address - Fax:844-320-2600
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10-03AP-PL103T00000X
OHP.7125103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1144763574OtherGROUP NPI