MEDICARE: STAIRSTEP FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1588965768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAIRSTEP FOUNDATION

Provider Business Mailing Address
First Line	:	1404 14TH AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-3111
Country	:	US
Telephone Number	:	612-521-3110
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 14TH AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-3111
Country	:	US
Telephone Number	:	612-521-3110
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MS. WILLETTE WHITTED
Credential	:	CD(DONA)
Telephone Number	:	612-251-5317

Provider Enumeration Date	:	11/04/2010
Last Update Date	:	11/04/2010

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Directions to “STAIRSTEP FOUNDATION ” Practice Location

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