Provider Demographics
NPI:1235720673
Name:BRINKMAN, JULIE LYNN
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:BRINKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 33RD ST NW
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912-6059
Mailing Address - Country:US
Mailing Address - Phone:507-438-8148
Mailing Address - Fax:
Practice Address - Street 1:810 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:MN
Practice Address - Zip Code:55909-9764
Practice Address - Country:US
Practice Address - Phone:507-582-3263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
200035224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant