Most Relevant Information
Provider Data
| NPI Number: | 1003389719 |
| Provider Name: | KELLY L BRIGHT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/04/2019 |
| Last Updated: | 01/04/2019 |
Provider Practice Location
1670 CORPORATE CIR STE 100
PETALUMA
CA
949546947
Practice Location Phone/Fax
| Phone: | 7073082121 |
| Fax: |
Provider Mailing Location
5333 EUNICE ST
ROHNERT PARK
CA
949281822
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |