Healthcare Provider Details

I. General information

NPI: 1871400077
Provider Name (Legal Business Name): HANNAH BRESTOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3740 S UNIVERSITY DR STE 201
FORT WORTH TX
76109-3700
US

IV. Provider business mailing address

5800 RIDGEROCK CT
FORT WORTH TX
76132-2631
US

V. Phone/Fax

Practice location:
  • Phone: 817-415-0908
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number89980
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: