Provider Demographics
NPI:1720124431
Name:BRINKSCHROEDER, DEANN J (OTR L CLT)
Entity Type:Individual
Prefix:MRS
First Name:DEANN
Middle Name:J
Last Name:BRINKSCHROEDER
Suffix:
Gender:F
Credentials:OTR L CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 CEDAR PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-2283
Mailing Address - Country:US
Mailing Address - Phone:563-264-8638
Mailing Address - Fax:563-264-8639
Practice Address - Street 1:2023 CEDAR PLAZA DR
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2283
Practice Address - Country:US
Practice Address - Phone:563-264-8638
Practice Address - Fax:563-264-8639
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01190225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0445486Medicaid
IAI12530Medicare ID - Type Unspecified