Provider Demographics
NPI:1295072072
Name:TIERWANDA BRIGHT
Entity type:Organization
Organization Name:TIERWANDA BRIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TIERWANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RMHCI
Authorized Official - Phone:352-361-0984
Mailing Address - Street 1:2 DOGWOOD LOOP AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-5658
Mailing Address - Country:US
Mailing Address - Phone:352-361-0984
Mailing Address - Fax:
Practice Address - Street 1:2 DOGWOOD LOOP AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-5658
Practice Address - Country:US
Practice Address - Phone:352-361-0984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 10223251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health