Provider Demographics
NPI:1457688194
Name:BRIGHT START SPEECH AND LANGUAGE SERVICES, LTD.
Entity Type:Organization
Organization Name:BRIGHT START SPEECH AND LANGUAGE SERVICES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP/L
Authorized Official - Phone:815-997-4501
Mailing Address - Street 1:141 BRISTLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROCKTON
Mailing Address - State:IL
Mailing Address - Zip Code:61072-3217
Mailing Address - Country:US
Mailing Address - Phone:815-997-4501
Mailing Address - Fax:815-624-8087
Practice Address - Street 1:141 BRISTLEWOOD CT
Practice Address - Street 2:
Practice Address - City:ROCKTON
Practice Address - State:IL
Practice Address - Zip Code:61072-3217
Practice Address - Country:US
Practice Address - Phone:815-997-4501
Practice Address - Fax:815-624-8087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty