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NPI Code Detail

MEDICARE: ALICIA BRIGHAM LPC

MEDICARE: ALICIA BRIGHAM LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor70117TX

General Provider Information

NPI Number : 1376020958
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA BRIGHAM LPC
Provider Business Mailing Address
First Line : 705 BRAY CENTRAL DR APT 7306
Second Line :
City : ALLEN
State : TX
Zip : 75013-6375
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12959 JUPITER RD STE 140
Second Line :
City : DALLAS
State : TX
Zip : 75238-3200
Country : US
Telephone Number : 817-879-2215
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2018
Last Update Date : 07/25/2018

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Directions to “ ALICIA BRIGHAM LPC” Practice Location

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