Healthcare Provider Details

I. General information

NPI: 1609744085
Provider Name (Legal Business Name): JULIE NISSA BLOCH BRIGHT MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7372 CHESAPEAKE CIR
BOYNTON BEACH FL
33436-8545
US

IV. Provider business mailing address

7372 CHESAPEAKE CIR
BOYNTON BEACH FL
33436-8545
US

V. Phone/Fax

Practice location:
  • Phone: 754-224-1000
  • Fax: 844-466-3889
Mailing address:
  • Phone: 754-224-1000
  • Fax: 844-466-3889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number05315
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: