Healthcare Provider Details

I. General information

NPI: 1760934376
Provider Name (Legal Business Name): OLIVIA BRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2016
Last Update Date: 10/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 W 26TH AVE BLDG. C, SUITE 217
DENVER CO
80211-5308
US

IV. Provider business mailing address

2460 W 26TH AVE BLDG. C, SUITE 217
DENVER CO
80211-5308
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-7108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: