Provider Demographics
NPI:1912174236
Name:BRIGHT, PEARLA KAY (OT)
Entity Type:Individual
Prefix:
First Name:PEARLA
Middle Name:KAY
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 CONTENTNEA LN
Mailing Address - Street 2:
Mailing Address - City:GRIFTON
Mailing Address - State:NC
Mailing Address - Zip Code:28530-8531
Mailing Address - Country:US
Mailing Address - Phone:252-527-5146
Mailing Address - Fax:
Practice Address - Street 1:907 CUNNINGHAM RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1825
Practice Address - Country:US
Practice Address - Phone:252-527-5146
Practice Address - Fax:252-520-7635
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0328225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0328OtherNC STATE OT LICENSE