Organization
BLUE STARS THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET HORMBERG MOT, OTR/L (CO-OWNER, CO-FOUNDER)
(314) 650-9288
Entity
Organization
Contact information
Practice address
1101 EDWARD TERRACE, APT A, ST. LOUIS, MO 63117
(314) 380-3088
Mailing address
PO BOX 179466, ST. LOUIS, MO 63117
(314) 380-3088
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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