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General NPI Number Information
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NPI Number | 1518316447
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Entity Type | Organization
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Legal Business Name | BRIGHTER DAY HEALTH LLC
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | 400 MCKINLEY AVE
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City | HARRISVILLE
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State | WV
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Zip | 26362-1150
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Country | US
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Telephone | 832-742-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 12521 NACOGDOCHES RD 202
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City | SAN ANTONIO
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State | TX
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Zip | 78217-2131
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Country | US
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Telephone | 832-742-0117
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | NIDIA MARTINEZ
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Credential |
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Telephone | 832-742-0117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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