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General NPI Number Information
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NPI Number | 1174222871
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Entity Type | Organization
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Legal Business Name | BRIGHT DAKROUB LLC.
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 2032 E SQUARE LAKE RD
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City | TROY
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State | MI
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Zip | 48085-3338
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Country | US
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Telephone | 313-645-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 23500 PARK ST STE 3
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City | DEARBORN
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State | MI
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Zip | 48124-2598
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Country | US
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Telephone | 313-645-2422
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Fax |
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Authorized Official
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Title or Position | LICENSE HOLDER
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Name | MRS. SONIA SALMAN
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Credential |
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Telephone | 313-645-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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