Healthcare Provider Details

I. General information

NPI: 1174433361
Provider Name (Legal Business Name): BORN TO THRIVE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WEINLAND DR
NEW CARLISLE OH
45344-2927
US

IV. Provider business mailing address

105 WEINLAND DR
NEW CARLISLE OH
45344-2927
US

V. Phone/Fax

Practice location:
  • Phone: 937-776-0209
  • Fax:
Mailing address:
  • Phone: 937-776-0209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: HARLEY NICHOLE ADAMSON
Title or Position: OWNER/OCCUPATIONAL THERAPIST
Credential: OTD, OTR/L
Phone: 937-776-0209