Individual
MARISSA JEAN BRANDLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
768 W CASTLEBURY CIR, SALINE, MI 48176-1348
(734) 219-8361
Mailing address
768 W CASTLEBURY CIR, SALINE, MI 48176-1348
(734) 219-8361
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12366
—
MI
Enumeration date
09/17/2020
Last updated
09/17/2020
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