Healthcare Provider Details

I. General information

NPI: 1508961053
Provider Name (Legal Business Name): STEP AHEAD PEDIATRIC REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5695 BLAINE AVE
INVER GROVE HEIGHTS MN
55076-1619
US

IV. Provider business mailing address

5695 BLAINE AVE
INVER GROVE HEIGHTS MN
55076-1619
US

V. Phone/Fax

Practice location:
  • Phone: 651-554-9940
  • Fax: 651-554-9941
Mailing address:
  • Phone: 651-554-9940
  • Fax: 651-554-9941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number201297
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number103226
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7330
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7974
License Number StateMN

VIII. Authorized Official

Name: MRS. JULIE RAE SKOKAN
Title or Position: SPEECH-LANGUAGE PATHOLOGIST OWNER
Credential: MACCCSLP CEO
Phone: 651-554-9940