Provider Demographics
NPI:1457444747
Name:BRIGHT, LAQUITTA NICOLE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LAQUITTA
Middle Name:NICOLE
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 PULASKI HWY
Mailing Address - Street 2:APT. B-13
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4581
Mailing Address - Country:US
Mailing Address - Phone:615-403-5832
Mailing Address - Fax:
Practice Address - Street 1:2710 TROTWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4903
Practice Address - Country:US
Practice Address - Phone:931-388-7182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3527225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist