Organization Name: | BRIGHT STAR THERAPY, PLLC |
NPI Number: | 1689803645 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LETICIA G. ROSA (SPEECH LANGUAGE PATHOLOGIST) |
Mailing Address: | 201 N Fm 3167 Suite 103 Rio Grande City |
State: | TX US |
Postal Code: | 785826724 |
Phone Number: | 9562631756 |
Fax Number: | 9562631758 |
NPI Enumeration Date: | 07/10/2009 |
NPI Last Update Date: | 07/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 102581 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |