Provider Demographics
NPI:1801402110
Name:OLTMANNS, BREANNA (LSW)
Entity Type:Individual
Prefix:MRS
First Name:BREANNA
Middle Name:
Last Name:OLTMANNS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S CHERRY ST STE 217
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1704
Mailing Address - Country:US
Mailing Address - Phone:720-653-2728
Mailing Address - Fax:
Practice Address - Street 1:600 S CHERRY ST STE 217
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1704
Practice Address - Country:US
Practice Address - Phone:720-653-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CO00099249501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor