Provider Demographics
NPI:1881861094
Name:BRIGHTWELL, ERIN M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:BRIGHTWELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2909
Mailing Address - Country:US
Mailing Address - Phone:415-548-0630
Mailing Address - Fax:
Practice Address - Street 1:1508 FILLMORE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3598
Practice Address - Country:US
Practice Address - Phone:415-548-0630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15960235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist