Healthcare Provider Details

I. General information

NPI: 1952595498
Provider Name (Legal Business Name): CHILDREN'S DEVELOPMENTAL STEPPING STONES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 N POST RD STE 100
INDIANAPOLIS IN
46216-2221
US

IV. Provider business mailing address

5665 N POST RD STE 100
INDIANAPOLIS IN
46216-2222
US

V. Phone/Fax

Practice location:
  • Phone: 317-546-0000
  • Fax:
Mailing address:
  • Phone: 317-546-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. RION LAHR
Title or Position: MEMBER
Credential: M.A. CCC-SLP
Phone: 317-727-6744