Healthcare Provider Details

I. General information

NPI: 1548865199
Provider Name (Legal Business Name): BRANDI CLAERHOUT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRANDI MIDDLETON

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 CAMPUS DR N
WATERFORD MI
48328-2754
US

IV. Provider business mailing address

4126 HEATHER HILL DR
GRAND BLANC MI
48439-7998
US

V. Phone/Fax

Practice location:
  • Phone: 248-475-6300
  • Fax:
Mailing address:
  • Phone: 989-414-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401001927
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: