Organization
SHINING START, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANY INGRAM (ITDS)
(850) 814-1473
Entity
Organization
Contact information
Practice address
1913 GRANT AVE, PANAMA CITY, FL 32405-1525
(850) 814-1473
Mailing address
1913 GRANT AVE, PANAMA CITY, FL 32405-1525
(850) 814-1473
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/01/2013
Last updated
07/31/2014
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