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General NPI Number Information
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NPI Number | 1538673561
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Entity Type | Individual
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Provider Name | AMANDA NICOLE BRIGHT
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Gender | Female
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 11/13/2018
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Provider Practice Location Address
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Address Line | 101 CLEVELAND AVE NW
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City | CANTON
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State | OH
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Zip | 44702-1707
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Country | US
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Telephone | 330-455-0498
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Fax |
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Provider Business Mailing Address
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Address Line | 2140 7TH ST
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44221-3113
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Country | US
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Telephone | 330-988-3175
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | COND.2017302
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP.13191
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License Number State | OH
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