Provider Demographics
NPI:1619700374
Name:SKILLFUL STEPS THERAPY LLC
Entity type:Organization
Organization Name:SKILLFUL STEPS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMELUNG
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:602-904-9818
Mailing Address - Street 1:2256 W SIERRA ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-3603
Mailing Address - Country:US
Mailing Address - Phone:602-904-9818
Mailing Address - Fax:
Practice Address - Street 1:2256 W SIERRA ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3603
Practice Address - Country:US
Practice Address - Phone:602-904-9818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty