Healthcare Provider Details
I. General information
NPI: 1225968837
Provider Name (Legal Business Name): BRIGHT STAR - ABA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
355 CHAMBERLAIN AVE
BRIDGEPORT CT
06606-3949
US
IV. Provider business mailing address
355 CHAMBERLAIN AVE
BRIDGEPORT CT
06606-3949
US
V. Phone/Fax
- Phone: 914-486-2438
- Fax:
- Phone: 914-486-2438
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CANDICE
KRISTINA
RANGEL
Title or Position: BOARD CERTIFIED BEHAVIORAL ANALYST
Credential: BCBA
Phone: 914-486-2438