| Doctor Name: | MR. BRANDON MINTON |
| NPI Number: | 1134369382 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS, LLPC |
| License Number: | 6401010890 |
| Business Practice Address: | 20651 W Warren St Dearborn Heights, MI - 481272622 |
| Business Phone Number: | 3132713050 |
| Business Fax Number: | |
| Mailing Address: | 18261 Prospect St, MELVINDALE |
| State: | MI |
| Postal Code: | 481221519 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/01/2009 |
| NPI Last Update Date: | 03/01/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401010890 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |