MEDICARE: DENNIS, MOYE, BRANSTETTER & ASSOCIATES, P.C.

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1962611137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENNIS, MOYE, BRANSTETTER & ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	1750 S TELEGRAPH RD STE 101
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0177
Country	:	US
Telephone Number	:	248-451-9085
Fax Number	:	248-451-9089

Provider Business Practice Location Address
First Line	:	1750 S TELEGRAPH RD STE 101
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0177
Country	:	US
Telephone Number	:	248-451-9085
Fax Number	:	248-451-9089

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN BRANSTETTER
Credential	:	LMSW
Telephone Number	:	248-451-9085

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	04/21/2018

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