Provider Demographics
NPI:1770070799
Name:BRIGHTWELL, FAYE (MA)
Entity type:Individual
Prefix:MRS
First Name:FAYE
Middle Name:
Last Name:BRIGHTWELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-1777
Mailing Address - Country:US
Mailing Address - Phone:419-720-6811
Mailing Address - Fax:419-720-6839
Practice Address - Street 1:4260 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-2048
Practice Address - Country:US
Practice Address - Phone:812-584-4244
Practice Address - Fax:812-584-4244
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator