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NPI Code Detail

MEDICARE: MR. BRANDON MINTON MS, LLPC

MEDICARE:  MR. BRANDON  MINTON  MS, LLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6401010890MI

General Provider Information

NPI Number : 1134369382
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRANDON MINTON MS, LLPC
Provider Business Mailing Address
First Line : 18261 PROSPECT ST
Second Line :
City : MELVINDALE
State : MI
Zip : 48122-1519
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20651 W WARREN ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-2622
Country : US
Telephone Number : 313-271-3050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2009
Last Update Date : 03/01/2009

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Directions to “ MR. BRANDON MINTON MS, LLPC” Practice Location

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