Healthcare Provider Details

I. General information

NPI: 1942122429
Provider Name (Legal Business Name): BREANA MARTINA HOOTON LLMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BREANA MARTINA HOOVER

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N WEST AVE
JACKSON MI
49202-2179
US

IV. Provider business mailing address

2240 SAMPER LN APT 10
HOLT MI
48842-7766
US

V. Phone/Fax

Practice location:
  • Phone: 517-789-1200
  • Fax:
Mailing address:
  • Phone: 660-620-1486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4151001226
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: