Provider Demographics
NPI:1215304076
Name:BRIGHT, STEPHANIE (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 KATHLEEN DR
Mailing Address - Street 2:
Mailing Address - City:FORT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2064
Mailing Address - Country:US
Mailing Address - Phone:859-240-2425
Mailing Address - Fax:
Practice Address - Street 1:2865 CHANCELLOR DR STE 105
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3913
Practice Address - Country:US
Practice Address - Phone:859-426-5666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYSLPLPA00220266235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist