MEDICARE: ELIZABETH BRIGHT LPC

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	101Y00000X	Counselor	62600	TX

General Provider Information

NPI Number	:	1952535072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BRIGHT LPC

Provider Business Mailing Address
First Line	:	515 BUSBY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-3231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 BUSBY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-3231
Country	:	US
Telephone Number	:	210-826-7447
Fax Number	:

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

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	04/12/2010

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