Provider Demographics
NPI:1003359522
Name:BRINKMAN-WILKINSON, JAYNE (BS)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:BRINKMAN-WILKINSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 N HAGADORN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-1151
Mailing Address - Country:US
Mailing Address - Phone:248-756-0878
Mailing Address - Fax:
Practice Address - Street 1:180 N HAGADORN ST
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-1151
Practice Address - Country:US
Practice Address - Phone:248-756-0878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker