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General NPI Number Information
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NPI Number | 1922666866
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Entity Type | Organization
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Legal Business Name | BRIGHT MINDS PSYCHIATRY,PLLC
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 575 WASHINGTON ST STE 1B
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City | CANTON
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State | MA
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Zip | 02021-3011
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Country | US
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Telephone | 508-375-8980
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Fax | 508-734-5005
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Provider Business Mailing Address
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Address Line | 575 WASHINGTON ST STE 1B
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City | CANTON
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State | MA
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Zip | 02021-3011
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Country | US
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Telephone | 508-375-8980
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Fax | 508-734-5005
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRYAN TERAN-ZUNIGA
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Credential | PMHNP-BC
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Telephone | 508-375-8980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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