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Organization
LYGHT BULB MOMENTS LLC
Active
Organization
LYGHT BULB MOMENTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINEY RAY (NP)
(678) 701-4679
Entity
Organization
Contact information
Practice address
54 HOWE STREET, BUILDING A ; PO BOX 105 SUITE 105, RUTLAND, VT 05701-3802
(888) 987-3991
(888) 502-6598
Mailing address
12247 BIG CANOE, BIG CANOE, GA 30143-5161
(888) 987-3991
(888) 502-6598
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/25/2021
Last updated
10/29/2025
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