Provider Demographics
NPI:1649934043
Name:BRIGHT BEHAVIOR THERAPY
Entity type:Organization
Organization Name:BRIGHT BEHAVIOR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LBA, BCBA
Authorized Official - Phone:313-645-2422
Mailing Address - Street 1:175 BAY STATE DR
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5203
Mailing Address - Country:US
Mailing Address - Phone:508-505-1200
Mailing Address - Fax:
Practice Address - Street 1:175 BAY STATE DR
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5203
Practice Address - Country:US
Practice Address - Phone:508-505-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHT BEHAVIOR THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty