Provider Demographics
NPI:1275309353
Name:BRAIN JUNCTION THERAPY
Entity Type:Organization
Organization Name:BRAIN JUNCTION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER AND OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:BLATUS
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L, M ED
Authorized Official - Phone:978-225-0918
Mailing Address - Street 1:76 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-2011
Mailing Address - Country:US
Mailing Address - Phone:978-804-8831
Mailing Address - Fax:
Practice Address - Street 1:76 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2011
Practice Address - Country:US
Practice Address - Phone:978-804-8831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty