Provider Demographics
NPI:1275404436
Name:BRATKE, ISABELLA HANNA (ATS)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:HANNA
Last Name:BRATKE
Suffix:
Gender:F
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19607 PRINCE DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-1774
Mailing Address - Country:US
Mailing Address - Phone:586-488-5520
Mailing Address - Fax:
Practice Address - Street 1:19607 PRINCE DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-1774
Practice Address - Country:US
Practice Address - Phone:586-488-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer