Provider Demographics
NPI:1538740790
Name:BRETTMANN, BREEZY ELSIA (RBT)
Entity type:Individual
Prefix:
First Name:BREEZY
Middle Name:ELSIA
Last Name:BRETTMANN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:BREEZY
Other - Middle Name:ELSIA
Other - Last Name:BRETTMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:14928 STUDEBAKER PL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4575
Mailing Address - Country:US
Mailing Address - Phone:720-517-4333
Mailing Address - Fax:
Practice Address - Street 1:3131 S VAUGHN WAY STE 110
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3501
Practice Address - Country:US
Practice Address - Phone:719-597-0822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician