Healthcare Provider Details

I. General information

NPI: 1598400012
Provider Name (Legal Business Name): JULIA CAROLYN BRINK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 22ND ST
BAY CITY MI
48708-7612
US

IV. Provider business mailing address

2535 22ND ST
BAY CITY MI
48708-7612
US

V. Phone/Fax

Practice location:
  • Phone: 989-891-9800
  • Fax:
Mailing address:
  • Phone: 989-891-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: