Provider Demographics
NPI:1346870029
Name:BRUMMEL, REBECCA MARIE (BS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:BRUMMEL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MARIE
Other - Last Name:CORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:3310 EAGLE PARK DR NE STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-4574
Mailing Address - Country:US
Mailing Address - Phone:616-336-3909
Mailing Address - Fax:
Practice Address - Street 1:3310 EAGLE PARK DR NE STE 100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-4574
Practice Address - Country:US
Practice Address - Phone:616-825-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker