| Doctor Name: | BREN SHANTZ |
| NPI Number: | 1003283169 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 6401014444 |
| Business Practice Address: | 1049 E Newell St White Cloud, MI - 493498795 |
| Business Phone Number: | 2316847565 |
| Business Fax Number: | |
| Mailing Address: | 1049 E Newell St, WHITE CLOUD |
| State: | MI |
| Postal Code: | 493498795 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/25/2015 |
| NPI Last Update Date: | 08/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401014444 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |