Healthcare Provider Details
I. General information
NPI: 1124950241
Provider Name (Legal Business Name): RISE & SHINE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1304 SOUTHWEST BLVD STE B
JEFFERSON CITY MO
65109-3402
US
IV. Provider business mailing address
309 JOE LN
JEFFERSON CITY MO
65101-5533
US
V. Phone/Fax
- Phone: 573-263-5828
- Fax:
- Phone: 573-263-5828
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEXA
TRUSK
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MA CCC-SLP
Phone: 573-263-5828