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General NPI Number Information
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NPI Number | 1942968425
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Entity Type | Organization
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Legal Business Name | BRIGHT LIGHT COUNSELING & COACHING, LLC
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 2140 MCGEE RD STE A4200
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City | SNELLVILLE
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State | GA
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Zip | 30078-7051
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Country | US
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Telephone | 470-502-5381
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Fax |
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Provider Business Mailing Address
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Address Line | 705 STONEBRIDGE PARK CIR
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City | LITHONIA
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State | GA
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Zip | 30058-9047
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Country | US
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Telephone | 404-468-3160
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | KIMLYN FRETT
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Credential |
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Telephone | 404-468-3160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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