Basic Information
| Provider Information | |||||||||
| NPI: | 1881719011 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRETZER | ||||||||
| FirstName: | TAMMY | ||||||||
| MiddleName: | SHAWN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.A. .L.P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 46270 LOOKOUT DR | ||||||||
| Address2: | |||||||||
| City: | MACOMB | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480446236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5864687636 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 15945 CANAL RD | ||||||||
| Address2: | |||||||||
| City: | CLINTON TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480381610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5864162300 | ||||||||
| FaxNumber: | 5864162311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 03/22/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 6401008636 | MI | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.