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General NPI Number Information
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NPI Number | 1164957890
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Entity Type | Organization
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Legal Business Name | BRAIN BRIGHT THERAPY LLC
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 5164 MONROE ST
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City | TOLEDO
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State | OH
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Zip | 43623-3471
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Country | US
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Telephone | 419-279-9576
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Fax | 419-214-1233
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Provider Business Mailing Address
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Address Line | 5164 MONROE ST
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City | TOLEDO
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State | OH
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Zip | 43623-3471
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Country | US
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Telephone | 419-279-9576
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Fax | 419-214-1233
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE LYNN NELSON
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Credential | OTR/L
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Telephone | 419-410-4341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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