Provider Demographics
NPI:1861668956
Name:SMALL STEPS THERAPY, LLC
Entity Type:Organization
Organization Name:SMALL STEPS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:815-405-7990
Mailing Address - Street 1:15043 AUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-1330
Mailing Address - Country:US
Mailing Address - Phone:815-405-7990
Mailing Address - Fax:815-207-7815
Practice Address - Street 1:15043 AUSTIN DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-1330
Practice Address - Country:US
Practice Address - Phone:815-405-7990
Practice Address - Fax:815-207-7815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.010384252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency