Provider Demographics
NPI:1003924853
Name:BRAMLETT, JENNIFER LEE (SOCIAL SERVICES TECH)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEE
Last Name:BRAMLETT
Suffix:
Gender:F
Credentials:SOCIAL SERVICES TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6057 URBAN DR
Mailing Address - Street 2:
Mailing Address - City:EAST CHINA
Mailing Address - State:MI
Mailing Address - Zip Code:48054-4750
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:515 S PARKER ST
Practice Address - Street 2:SUITE D
Practice Address - City:MARINE CITY
Practice Address - State:MI
Practice Address - Zip Code:48039-3572
Practice Address - Country:US
Practice Address - Phone:810-765-5010
Practice Address - Fax:810-765-8451
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6803080829247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other