Healthcare Provider Details

I. General information

NPI: 1063058709
Provider Name (Legal Business Name): BRANDY SCHILLING MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2019
Last Update Date: 11/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2280 E GRAND RIVER AVE
HOWELL MI
48843-8503
US

IV. Provider business mailing address

622 E GRAND RIVER AVE
HOWELL MI
48843-2329
US

V. Phone/Fax

Practice location:
  • Phone: 517-546-4126
  • Fax: 517-546-1300
Mailing address:
  • Phone: 517-548-0081
  • Fax: 517-548-0498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801104806
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: