Provider Demographics
NPI:1164843348
Name:HAHN, GRETCHEN (LMFT)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 E REDWOOD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:CA
Mailing Address - Zip Code:95437-3549
Mailing Address - Country:US
Mailing Address - Phone:707-357-6546
Mailing Address - Fax:
Practice Address - Street 1:337 E REDWOOD AVE STE B
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:CA
Practice Address - Zip Code:95437-3549
Practice Address - Country:US
Practice Address - Phone:707-357-6546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-14
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95764106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist