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General NPI Number Information
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NPI Number | 1396432860
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Entity Type | Organization
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Legal Business Name | BRIGHTSTONE THERAPY LLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 1650 WELLS RD
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City | ORANGE PARK
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State | FL
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Zip | 32073-2318
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Country | US
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Telephone | 718-483-5093
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Fax |
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Provider Business Mailing Address
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Address Line | 180 PHILLIPS HILL RD STE 1A
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City | NEW CITY
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State | NY
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Zip | 10956-4132
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | BRIAN KOHN
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Credential |
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Telephone | 718-483-5093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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