Provider Demographics
NPI:1932650009
Name:EBRIGHT, MICHELE DANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:DANA
Last Name:EBRIGHT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 BUSH RIVER DR
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-3179
Mailing Address - Country:US
Mailing Address - Phone:434-808-9000
Mailing Address - Fax:434-392-5789
Practice Address - Street 1:214 BUSH RIVER DR
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-3179
Practice Address - Country:US
Practice Address - Phone:434-808-9000
Practice Address - Fax:434-392-5789
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002831103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical