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General NPI Number Information
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NPI Number | 1447711288
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Entity Type | Individual
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Provider Name | BROOKE BRIGHT
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Gender | Female
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 6821 JACKSON ST
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-2513
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Country | US
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Telephone | 470-584-9417
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Fax |
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Provider Business Mailing Address
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Address Line | 6533 RIVER RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2229
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Country | US
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Telephone | 727-534-3234
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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 | 1-22-61381
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License Number State | GA
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