Most Relevant Information
Provider Data
NPI Number: | 1003283169 |
Provider Name: | BREN SHANTZ LPC, LLP |
Entity Type: | Individual |
Taxonomy Code: | 103TC1900X |
Specialty: | Psychologist |
License Number: | 6301016034 |
Most Important Dates
Enumeration Date: | 08/25/2015 |
Last Updated: | 01/03/2019 |
Provider Practice Location
4890 11 MILE RD NE
ROCKFORD
MI
493418477
Practice Location Phone/Fax
Phone: | 6164391866 |
Fax: |
Provider Mailing Location
3201 BURTON ST SE
GRAND RAPIDS
MI
495464301
Provider Mailing Phone/Fax
Phone: | 6164391866 |
Fax: |