Doctor Name: | IAN MICHAEL BRAND |
NPI Number: | 1538532262 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LLMSW |
License Number: | 6801098559 |
Business Practice Address: | 1000 W Cedar St Standish, MI - 486589421 |
Business Phone Number: | 9898465004 |
Business Fax Number: | |
Mailing Address: | 1000 W Cedar St, Po Box 1188 STANDISH |
State: | MI |
Postal Code: | 486589421 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/03/2015 |
NPI Last Update Date: | 11/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801098559 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |