Provider Demographics
NPI:1962856476
Name:STEPPING STONES THERAPEUTICS
Entity Type:Organization
Organization Name:STEPPING STONES THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:484-904-2004
Mailing Address - Street 1:1240 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19076-2029
Mailing Address - Country:US
Mailing Address - Phone:484-904-2004
Mailing Address - Fax:
Practice Address - Street 1:1240 MADISON AVE
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:PA
Practice Address - Zip Code:19076-2029
Practice Address - Country:US
Practice Address - Phone:484-904-2004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-14-17344103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty