Provider Demographics
NPI:1417115395
Name:BROUWER, BRITTANY CHRISTINE (MA, OTR)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:CHRISTINE
Last Name:BROUWER
Suffix:
Gender:F
Credentials:MA, OTR
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:CHRISTINE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, OTR
Mailing Address - Street 1:1900 44TH ST SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-5008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:359 DIVISION AVE S
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4537
Practice Address - Country:US
Practice Address - Phone:616-685-3800
Practice Address - Fax:616-235-0913
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201005228225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist