Provider Demographics
NPI:1174783955
Name:BREITNER, BINA (LMFT)
Entity type:Individual
Prefix:
First Name:BINA
Middle Name:
Last Name:BREITNER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4114 E CALLE EL CENTRO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3417
Mailing Address - Country:US
Mailing Address - Phone:520-820-7930
Mailing Address - Fax:520-325-9475
Practice Address - Street 1:4114 E CALLE EL CENTRO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3417
Practice Address - Country:US
Practice Address - Phone:520-820-7930
Practice Address - Fax:520-325-9475
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1150106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist