Provider Demographics
NPI:1790975381
Name:SCHULZ, BRANDIE ALICIA (MSW)
Entity Type:Individual
Prefix:
First Name:BRANDIE
Middle Name:ALICIA
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:BRANDIE
Other - Middle Name:ALICIA
Other - Last Name:MELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:7425 WILLIS RD RM P114
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8919
Practice Address - Country:US
Practice Address - Phone:734-714-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010928721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical