Provider Demographics
NPI:1326502006
Name:BRANTLEY, SHELDA S
Entity Type:Individual
Prefix:MS
First Name:SHELDA
Middle Name:S
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 E 147TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-4153
Mailing Address - Country:US
Mailing Address - Phone:216-376-8060
Mailing Address - Fax:
Practice Address - Street 1:3427 E 147TH ST APT 2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-4153
Practice Address - Country:US
Practice Address - Phone:216-376-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-26
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator