Individual
BREANNA HACKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCP
Contact information
Practice address
45211 HELM ST., PLYMOUTH, MI 48170
(734) 525-9712
(480) 777-1345
Mailing address
45211 HELM ST, PLYMOUTH, MI 48170
(480) 777-0900
(480) 777-1345
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
08/04/2026
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