Provider Demographics
NPI:1639885429
Name:BRANSON, MESHIA MARIE
Entity Type:Individual
Prefix:
First Name:MESHIA
Middle Name:MARIE
Last Name:BRANSON
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 1:142 EAST AVE N
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-5642
Mailing Address - Country:US
Mailing Address - Phone:269-330-4484
Mailing Address - Fax:
Practice Address - Street 1:1302 PORTAGE PATH
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2034
Practice Address - Country:US
Practice Address - Phone:616-634-2923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician