Provider Demographics
NPI:1598650699
Name:FLINT, BRENDA JEAN (MSOTR/L)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:JEAN
Last Name:FLINT
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 LYNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-9270
Mailing Address - Country:US
Mailing Address - Phone:517-673-5134
Mailing Address - Fax:
Practice Address - Street 1:237 LYNBROOK DR
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-9270
Practice Address - Country:US
Practice Address - Phone:517-673-5134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001615225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist