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General NPI Number Information
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NPI Number | 1841904984
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Entity Type | Organization
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Legal Business Name | BRIGHT LIGHT THERAPY SOLUTIONS
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 11021 SW 232ND TER
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City | HOMESTEAD
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State | FL
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Zip | 33032-6306
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Country | US
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Telephone | 305-323-6335
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Fax |
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Provider Business Mailing Address
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Address Line | 11021 SW 232ND TER
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City | HOMESTEAD
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State | FL
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Zip | 33032-6306
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Country | US
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Telephone | 305-323-6335
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. MABELL ALCANTARA VARGAS
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Credential | MS
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Telephone | 305-323-6335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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