Organization
BRIGHT SPARK THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA WERNER SLP (SPEECH LANGUAGE PATHOLOGIST)
(904) 601-2079
Entity
Organization
Contact information
Practice address
3837 CARDINAL OAKS CIR, ORANGE PARK, FL 32065-4251
(904) 601-2079
Mailing address
3837 CARDINAL OAKS CIR, ORANGE PARK, FL 32065-4251
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/02/2022
Last updated
05/25/2022
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