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General NPI Number Information
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NPI Number | 1770099764
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Entity Type | Individual
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Provider Name | GRANT TALOR BRIGHT PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 2205 OLD HAMILTON PL STE 400
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City | GAINESVILLE
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State | GA
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Zip | 30507-8052
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Country | US
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Telephone | 678-400-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 5031 PEACH MOUNTAIN CIR
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City | GAINESVILLE
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State | GA
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Zip | 30507-8884
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Country | US
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Telephone | 678-400-2188
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3167
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License Number State | GA
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