Provider Demographics
NPI:1306176177
Name:COLEMAN, BRANDEN NEAL (BSW)
Entity type:Individual
Prefix:
First Name:BRANDEN
Middle Name:NEAL
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9063 COUGHLIN DR
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-8921
Mailing Address - Country:US
Mailing Address - Phone:810-877-9155
Mailing Address - Fax:
Practice Address - Street 1:54 SENECA ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2349
Practice Address - Country:US
Practice Address - Phone:248-836-0191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker