Provider Demographics
NPI:1235261967
Name:BRIGHT STARS THERAPY INC
Entity Type:Organization
Organization Name:BRIGHT STARS THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:SENIOR
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:352-246-5384
Mailing Address - Street 1:120 NW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2511
Mailing Address - Country:US
Mailing Address - Phone:352-246-5384
Mailing Address - Fax:352-376-0126
Practice Address - Street 1:120 NW 28TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2511
Practice Address - Country:US
Practice Address - Phone:352-246-5384
Practice Address - Fax:352-376-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT7345225XP0200X
FLOT10487225XP0200X
FLOT11408225XP0200X
FLOT10895225XP0200X
FLOT7559225XP0200X
FLOT10854225XP0200X
FLSA5471235Z00000X
FLSA6199235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty