Healthcare Provider Details

I. General information

NPI: 1215060561
Provider Name (Legal Business Name): BRIGHT AUDIOLOGY AND SPEECH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 S 3RD ST
SANFORD NC
27330-5662
US

IV. Provider business mailing address

1620 S 3RD ST
SANFORD NC
27330-5662
US

V. Phone/Fax

Practice location:
  • Phone: 919-774-3277
  • Fax: 919-771-1643
Mailing address:
  • Phone: 919-774-3277
  • Fax: 919-771-1643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2443
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2613
License Number StateNC

VIII. Authorized Official

Name: DR. ANGELA BRIGHT-PEARSON
Title or Position: CEO
Credential: AUD.CCC/A,SEP
Phone: 919-774-3277