Healthcare Provider Details

I. General information

NPI: 1003101833
Provider Name (Legal Business Name): STEPPINGSTONE THERAPEUTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20288 HIGHWAY 15 N SUITE 100
HUTCHINSON MN
55350-5684
US

IV. Provider business mailing address

20288 HIGHWAY 15 N SUITE 100
HUTCHINSON MN
55350-5684
US

V. Phone/Fax

Practice location:
  • Phone: 320-587-2326
  • Fax: 320-234-6358
Mailing address:
  • Phone: 320-587-2326
  • Fax: 320-234-6358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARY ANDERSON
Title or Position: CEO
Credential: MA, LAMFT
Phone: 320-587-2326