Provider Demographics
NPI:1083903439
Name:BRINTON, RACHAEL (LBSW)
Entity Type:Individual
Prefix:MISS
First Name:RACHAEL
Middle Name:
Last Name:BRINTON
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1376 HEATHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2787
Mailing Address - Country:US
Mailing Address - Phone:734-384-0034
Mailing Address - Fax:
Practice Address - Street 1:1376 HEATHERWOOD LN
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2787
Practice Address - Country:US
Practice Address - Phone:734-384-0034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802081463104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker