Organization
SHINING STAR THERAPY LLC
Active
Organization
SHINING STAR THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MYLENE BRAGGS OTR/L (MEMBER)
(708) 715-2555
Entity
Organization
Contact information
Practice address
8341 OLD TOWN DR, TAMPA, FL 33647-3335
(708) 715-2555
(708) 221-6638
Mailing address
8341 OLD TOWN DR, TAMPA, FL 33647-3335
(708) 715-2555
(708) 221-6638
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
14821
FL
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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