Organization
SHINING STARS THERAPY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN MARIE SOLOMON OTR/L (OCCUPATIONAL THERAPIST/OWNER)
(919) 557-8305
Entity
Organization
Contact information
Practice address
304 JUDD PLACE DRIVE, FUQUAY VARINA, NC 27526-2210
(919) 557-8305
Mailing address
304 JUDD PLACE DRIVE, FUQUAY VARINA, NC 27526-2210
(919) 557-8305
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
6790
NC
225XP0200X
Pediatric Occupational Therapist
6790
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7200363
—
NC
Enumeration date
01/04/2011
Last updated
11/16/2016
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