Provider Demographics
NPI:1639927155
Name:TINY STEPS LLC
Entity type:Organization
Organization Name:TINY STEPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-477-3789
Mailing Address - Street 1:5489 KY ROUTE 680 APT 2
Mailing Address - Street 2:
Mailing Address - City:GRETHEL
Mailing Address - State:KY
Mailing Address - Zip Code:41631-9081
Mailing Address - Country:US
Mailing Address - Phone:606-477-3789
Mailing Address - Fax:
Practice Address - Street 1:5489 KY ROUTE 680 APT 2
Practice Address - Street 2:
Practice Address - City:GRETHEL
Practice Address - State:KY
Practice Address - Zip Code:41631-9081
Practice Address - Country:US
Practice Address - Phone:606-477-3789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty