Provider Demographics
NPI:1689289134
Name:STEPPING STONES OCCUPATIONAL THERAPY, LLC
Entity Type:Organization
Organization Name:STEPPING STONES OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-877-8812
Mailing Address - Street 1:4 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1219
Mailing Address - Country:US
Mailing Address - Phone:978-877-8812
Mailing Address - Fax:
Practice Address - Street 1:4 MARLBORO RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1219
Practice Address - Country:US
Practice Address - Phone:978-877-8812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty