Provider Demographics
NPI:1881719011
Name:PRETZER, TAMMY SHAWN (MA LPC)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:SHAWN
Last Name:PRETZER
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46270 LOOKOUT DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-6236
Mailing Address - Country:US
Mailing Address - Phone:586-468-7636
Mailing Address - Fax:
Practice Address - Street 1:15945 CANAL RD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-1610
Practice Address - Country:US
Practice Address - Phone:586-416-2300
Practice Address - Fax:586-416-2311
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008636101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor