MEDICARE: ERIN BRIGHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	4109	MN

General Provider Information

NPI Number	:	1033982517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN BRIGHT

Provider Business Mailing Address
First Line	:	1387 HAZELWOOD WAY
Second Line	:
City	:	NORTHFIELD
State	:	MN
Zip	:	55057-4262
Country	:	US
Telephone Number	:	507-217-7991
Fax Number	:

Provider Business Practice Location Address
First Line	:	731 7TH ST E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-5048
Country	:	US
Telephone Number	:	651-967-2506
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	11/06/2023

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