Provider Demographics
NPI:1164929337
Name:STEP BY STEP THERAPY LLC
Entity Type:Organization
Organization Name:STEP BY STEP THERAPY LLC
Other - Org Name:STEP BY STEP THERAPY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABADIAS GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:678-963-5305
Mailing Address - Street 1:49 PIEDMONT DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-8118
Mailing Address - Country:US
Mailing Address - Phone:678-963-5305
Mailing Address - Fax:678-963-5399
Practice Address - Street 1:49 PIEDMONT DR STE 104
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-8118
Practice Address - Country:US
Practice Address - Phone:678-963-5305
Practice Address - Fax:678-963-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006968225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003202269AMedicaid