Provider Demographics
NPI:1811431273
Name:PRITCHETT-JOHNSON, BRANDI (PHD)
Entity type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:
Last Name:PRITCHETT-JOHNSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33493 W 14 MILE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1587
Mailing Address - Country:US
Mailing Address - Phone:269-615-4199
Mailing Address - Fax:
Practice Address - Street 1:33493 W 14 MILE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1587
Practice Address - Country:US
Practice Address - Phone:269-615-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016970103T00000X
FLPY 9018103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist