MEDICARE: CREATING BRIGHTER FUTURES, INC

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	235Z00000X	Speech-Language Pathologist
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1881939346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATING BRIGHTER FUTURES, INC

Provider Business Mailing Address
First Line	:	4201 VARSITY DR
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48108-5005
Country	:	US
Telephone Number	:	734-926-0740
Fax Number	:	734-369-8851

Provider Business Practice Location Address
First Line	:	4201 VARSITY DR
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48108-5005
Country	:	US
Telephone Number	:	734-926-0740
Fax Number	:	734-369-8851

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MS. JESSICA IRISH
Credential	:	BCBA
Telephone Number	:	734-926-0740

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	12/01/2016

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Directions to “CREATING BRIGHTER FUTURES, INC ” Practice Location

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