Provider Demographics
NPI:1003646852
Name:MORNING STAR THERAPY SERVICES
Entity type:Organization
Organization Name:MORNING STAR THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST, CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PHEASANT
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:570-534-8902
Mailing Address - Street 1:163 WHITE HERON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:E STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-6915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:163 WHITE HERON LAKE DR
Practice Address - Street 2:
Practice Address - City:E STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302-6915
Practice Address - Country:US
Practice Address - Phone:570-534-8902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency