Provider Demographics
NPI:1619187960
Name:BRIGHT, PENNY MELISSA (MS CCC-SP)
Entity Type:Individual
Prefix:MS
First Name:PENNY
Middle Name:MELISSA
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:MS CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3516
Mailing Address - Country:US
Mailing Address - Phone:608-233-6463
Mailing Address - Fax:608-236-0169
Practice Address - Street 1:3260 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3516
Practice Address - Country:US
Practice Address - Phone:608-233-6463
Practice Address - Fax:608-236-0169
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1744-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist