Provider Demographics
NPI:1386896918
Name:ARAUJO, BRENDA YVONNE (DPT)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:YVONNE
Last Name:ARAUJO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:YVONNE
Other - Last Name:HEINRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:330 N RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PARCHMENT
Mailing Address - State:MI
Mailing Address - Zip Code:49004-1310
Mailing Address - Country:US
Mailing Address - Phone:951-965-3853
Mailing Address - Fax:
Practice Address - Street 1:5659 STADIUM DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1932
Practice Address - Country:US
Practice Address - Phone:269-372-0436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8178225100000X
CA35368225100000X
FL24824225100000X
MI55010176212251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist