Provider Demographics
NPI:1982040853
Name:BATTLE, BRENDA RUTH (LBSW)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:RUTH
Last Name:BATTLE
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 1:4473 220TH AVE
Mailing Address - Street 2:
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677-8593
Mailing Address - Country:US
Mailing Address - Phone:231-832-2247
Mailing Address - Fax:231-832-3281
Practice Address - Street 1:4473 220TH AVE
Practice Address - Street 2:
Practice Address - City:REED CITY
Practice Address - State:MI
Practice Address - Zip Code:49677-8593
Practice Address - Country:US
Practice Address - Phone:231-832-2247
Practice Address - Fax:231-832-3281
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802070728171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator