Organization
BRIGHT LIGHT KIDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY BAENZIGER BCBA (BOARD CERTIFIED BEHAVIOR ANALYST)
(815) 953-6497
Entity
Organization
Contact information
Practice address
25651 BARROW RD, MANHATTAN, IL 60442-6248
(815) 953-6497
(815) 272-2229
Mailing address
25651 BARROW RD, MANHATTAN, IL 60442-6248
(815) 953-6497
(815) 272-2229
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-20703
IL
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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