Brooklynn Mikkel Benzine

Individual provider Active NPI Occupational Therapy Assistant · Spring Green, WI

NPI 1477449809 · NPPES record last updated Jun 13, 2025

Key facts

NPI
1477449809
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
7165-27 (WI)
Practice address
501 S Winsted St
Spring Green, WI 53588-9435
Phone
(608) 588-2586
NPI assigned
Jun 13, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7165-27WIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 7165-27 WI Yes

Addresses

Primary practice location

501 S Winsted St
Spring Green, WI 53588-9435

Mailing address

S11892 County Road G
Spring Green, WI 53588-9638
Phone (608) 556-6479

Other providers in Spring Green, WI

All providers in Spring Green, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.