Healthcare Provider Details

I. General information

NPI: 1588965768
Provider Name (Legal Business Name): STAIRSTEP FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2010
Last Update Date: 11/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 14TH AVE N
MINNEAPOLIS MN
55411-3111
US

IV. Provider business mailing address

1404 14TH AVE N
MINNEAPOLIS MN
55411-3111
US

V. Phone/Fax

Practice location:
  • Phone: 612-521-3110
  • Fax:
Mailing address:
  • Phone: 612-521-3110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MS. WILLETTE WHITTED
Title or Position: PROGRAM DIRECTOR
Credential: CD(DONA)
Phone: 612-251-5317