Provider Demographics
NPI:1750411336
Name:BRABANT, MARILYN JEAN (LMSW, CAADC)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:JEAN
Last Name:BRABANT
Suffix:
Gender:F
Credentials:LMSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3652
Mailing Address - Country:US
Mailing Address - Phone:989-907-2761
Mailing Address - Fax:989-907-2762
Practice Address - Street 1:3023 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3652
Practice Address - Country:US
Practice Address - Phone:989-907-9072
Practice Address - Fax:989-907-2762
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801086497104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker