Healthcare Provider Details

I. General information

NPI: 1619829090
Provider Name (Legal Business Name): BRYGHTON LEIGH PELTIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/10/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FOUNTAIN BEHAVIORAL SERVICES, 100 MAIN ST S
MINOT ND
58701
US

IV. Provider business mailing address

1909 HIAWATHA ST
MINOT ND
58701-6716
US

V. Phone/Fax

Practice location:
  • Phone: 701-389-9363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: