Healthcare Provider Details

I. General information

NPI: 1093555823
Provider Name (Legal Business Name): ALLISON BRINKMAN MA, LLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/29/2024
Certification Date: 05/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985 PARCHMENT DR SE
GRAND RAPIDS MI
49546-3659
US

IV. Provider business mailing address

985 PARCHMENT DR SE
GRAND RAPIDS MI
49546-3659
US

V. Phone/Fax

Practice location:
  • Phone: 616-209-9286
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451023673
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: