Provider Demographics
NPI:1710934591
Name:STEPPING STONE THERAPY, INC.
Entity Type:Organization
Organization Name:STEPPING STONE THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEANN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROACH
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:501-779-1286
Mailing Address - Street 1:111 LAGRUE DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-5836
Mailing Address - Country:US
Mailing Address - Phone:501-779-1286
Mailing Address - Fax:
Practice Address - Street 1:111 LAGRUE DR
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-5836
Practice Address - Country:US
Practice Address - Phone:501-779-1286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT1467225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty