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General NPI Number Information
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NPI Number | 1689562514
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Entity Type | Organization
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Legal Business Name | BRIGHTER BEGINNINGS THERAPY
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 4285 SPONSON DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86406-9271
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Country | US
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Telephone | 928-255-7975
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Fax |
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Provider Business Mailing Address
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Address Line | 379 METEOR LN
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-4938
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Country | US
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Telephone | 702-501-1143
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | CASSIDY PHOENIX
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Credential |
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Telephone | 702-501-1143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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