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General NPI Number Information
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NPI Number | 1558938662
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Entity Type | Organization
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Legal Business Name | BRIGHTENING WITHIN COUNSELING, LLC
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 352 E RIVERSIDE DR STE A-11
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City | SAINT GEORGE
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State | UT
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Zip | 84790-6758
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Country | US
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Telephone | 801-842-9554
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Fax |
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Provider Business Mailing Address
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Address Line | 486 S MORNING RETREAT DR
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City | IVINS
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State | UT
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Zip | 84738-1290
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Country | US
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Telephone | 801-214-4434
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANDRA CECILIA PETERSEN
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Credential | LMFT
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Telephone | 801-214-4434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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