Healthcare Provider Details

I. General information

NPI: 1477287001
Provider Name (Legal Business Name): STEPPING STONE KIDS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22655 BAYSHORE RD
PORT CHARLOTTE FL
33980-2018
US

IV. Provider business mailing address

22655 BAYSHORE RD
PORT CHARLOTTE FL
33980-2018
US

V. Phone/Fax

Practice location:
  • Phone: 239-293-7387
  • 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

VIII. Authorized Official

Name: CHRISTINE A BISCARDI
Title or Position: CEO
Credential:
Phone: 239-351-0675