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Organization

SHINNING STARS THERAPY PLLC

Active
Other names
TIBS for Kids
Organization subpart
No

Provider details

NPI number
Authorized official
RUCHI NAGRECHA MPT (PT)
(540) 431-0123
Entity
Organization

Contact information

Practice address
4100 LAFAYETTE CENTER DR, CHANTILLY, VA 20151-1233
(540) 431-0123
Mailing address
25669 TREMAINE TER, CHANTILLY, VA 20152-6303
(540) 431-0123

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician
133VN1004X
Pediatric Nutrition Registered Dietitian
224Z00000X
Occupational Therapy Assistant
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
225100000X
Physical Therapist
2251P0200X
Pediatric Physical Therapist
Primary
225200000X
Physical Therapy Assistant
225X00000X
Occupational Therapist
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
225XP0200X
Pediatric Occupational Therapist
2355S0801X
Speech-Language Assistant
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
08/24/2022
Last updated
08/24/2022
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