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General NPI Number Information
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NPI Number | 1215356324
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Entity Type | Individual
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Provider Name | MARJORIE BRIGHT BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 25 WOLF LN
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-5078
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Country | US
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Telephone | 914-474-6083
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Fax |
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Provider Business Mailing Address
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Address Line | 25 WOLF LANE
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569
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Country | US
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Telephone | 914-474-6083
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-14-15599
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License Number State | NY
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