Provider Demographics
NPI:1043306954
Name:BRETEY, DEBRA MARIE (MA,LMHC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:BRETEY
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4518 82ND AVENUE CT W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-2300
Mailing Address - Country:US
Mailing Address - Phone:253-566-4648
Mailing Address - Fax:
Practice Address - Street 1:4916 CENTER ST
Practice Address - Street 2:STE E
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-2348
Practice Address - Country:US
Practice Address - Phone:253-565-7038
Practice Address - Fax:253-565-4981
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health