Bridge to Brilliance Therapy LLC
NPI #1114707700 in Burnsville, Minnesota
Provider Information
- NPI Number
- 1114707700
- Entity Type
- Organization
- Organization Name
- Bridge to Brilliance Therapy LLC
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Oct 2, 2023
- Last Updated
- Oct 2, 2023
Practice Location
- Address
- 13740 NICOLLET AVE
- City
- Burnsville
- State
- Minnesota
- ZIP Code
- 55337-4003
- Phone
- (612) 987-3455
Authorized Official
- Name
- ANISA MOHAMED AHMED
- Title
- OWNER
- Phone
- (612) 987-3455
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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