Provider Demographics
NPI:1538279401
Name:STEP BY STEP PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:STEP BY STEP PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:954-596-2573
Mailing Address - Street 1:783 VILLA PORTOFINO CIR
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8061
Mailing Address - Country:US
Mailing Address - Phone:954-596-2573
Mailing Address - Fax:954-421-3990
Practice Address - Street 1:783 VILLA PORTOFINO CIR
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-8061
Practice Address - Country:US
Practice Address - Phone:954-596-2573
Practice Address - Fax:954-421-3990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty