Healthcare Provider Details

I. General information

NPI: 1861316093
Provider Name (Legal Business Name): BRIGHT LIGHT ADHD COAHCING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 SCOTLAND ST
HINGHAM MA
02043-3932
US

IV. Provider business mailing address

39 SCOTLAND ST
HINGHAM MA
02043-3932
US

V. Phone/Fax

Practice location:
  • Phone: 301-257-2522
  • Fax:
Mailing address:
  • Phone: 301-257-2522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY COGAN HOLLERAN
Title or Position: PEDIATRIC NURSE PRACTITIONER
Credential: PNP
Phone: 301-257-2522