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General NPI Number Information
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NPI Number | 1689387565
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Entity Type | Organization
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Legal Business Name | EDUCATIONAL SERVICES BRIGHT LIGHT
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 331 TILTON RD STE 12
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1201
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Country | US
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Telephone | 609-653-6459
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Fax |
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Provider Business Mailing Address
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Address Line | 331 TILTON RD STE 12
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1201
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Country | US
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Telephone | 609-653-6459
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | BRUCE RONALD GITTO
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Credential | LPC
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Telephone | 609-653-6459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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