Provider Demographics
NPI:1831245315
Name:BRIGHT-PEARSON, ANGELA (AUD CCC/A, SEP)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:BRIGHT-PEARSON
Suffix:
Gender:F
Credentials:AUD CCC/A, SEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5662
Mailing Address - Country:US
Mailing Address - Phone:919-774-3277
Mailing Address - Fax:919-776-3277
Practice Address - Street 1:1620 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5662
Practice Address - Country:US
Practice Address - Phone:919-774-3277
Practice Address - Fax:919-774-1643
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2443231H00000X
NC2613235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7418365Medicaid
NC346619Medicare PIN