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General NPI Number Information
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NPI Number | 1003924853
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Entity Type | Individual
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Provider Name | JENNIFER LEE BRAMLETT SOCIAL SERVICES TECH
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 515 S PARKER ST SUITE D
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City | MARINE CITY
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State | MI
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Zip | 48039-3572
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Country | US
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Telephone | 810-765-5010
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Fax | 810-765-8451
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Provider Business Mailing Address
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Address Line | 6057 URBAN DR
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City | EAST CHINA
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State | MI
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Zip | 48054-4750
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | 6803080829
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License Number State | MI
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