Provider Demographics
NPI:1750698031
Name:BRIGHT START, LLC
Entity type:Organization
Organization Name:BRIGHT START, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST/BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HAFNER
Authorized Official - Suffix:
Authorized Official - Credentials:MSP,CCC-SLP
Authorized Official - Phone:803-318-3811
Mailing Address - Street 1:720 GRACERN RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-7655
Mailing Address - Country:US
Mailing Address - Phone:803-929-1112
Mailing Address - Fax:803-929-1418
Practice Address - Street 1:720 GRACERN RD
Practice Address - Street 2:SUITE 450
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-7655
Practice Address - Country:US
Practice Address - Phone:803-929-1112
Practice Address - Fax:803-929-1418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty