Healthcare Provider Details

I. General information

NPI: 1114525839
Provider Name (Legal Business Name): STEPPING STONES SUPPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5221 NW 81ST TER
LAUDERHILL FL
33351-5050
US

IV. Provider business mailing address

5221 NW 81ST TER
LAUDERHILL FL
33351-5050
US

V. Phone/Fax

Practice location:
  • Phone: 786-224-9897
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: AMBER STONE
Title or Position: MANAGER
Credential:
Phone: 786-224-9897