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General NPI Number Information
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NPI Number | 1467133264
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Entity Type | Organization
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Legal Business Name | SHINING STARS THERAPY, LLC
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 2870 PIONEER CIR
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City | ZANESVILLE
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State | OH
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Zip | 43701-9235
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Country | US
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Telephone | 740-519-2212
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Fax |
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Provider Business Mailing Address
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Address Line | 2870 PIONEER CIR
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City | ZANESVILLE
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State | OH
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Zip | 43701-9235
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Country | US
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Telephone | 740-519-2212
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEA NEWSOM
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Credential | CCC-SLP
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Telephone | 740-591-2212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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