Organization
A SHINING LIGHT PEDIATRIC THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAITLIN A ROBERTS OTR (MANAGING MEMBER)
(256) 736-3056
Entity
Organization
Contact information
Practice address
7470 COUNTY ROAD 437, CULLMAN, AL 35057-3325
(256) 736-3056
Mailing address
7470 COUNTY ROAD 437, CULLMAN, AL 35057-3325
(256) 736-3056
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4624
ALABAMA BOARD OF OCCUPATIONAL THERAPY
AL
Enumeration date
05/24/2025
Last updated
06/06/2025
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