Healthcare Provider Details

I. General information

NPI: 1114893807
Provider Name (Legal Business Name): TINY STEPS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8810 AVENUE J
BROOKLYN NY
11236-3919
US

IV. Provider business mailing address

8810 AVENUE J
BROOKLYN NY
11236-3919
US

V. Phone/Fax

Practice location:
  • Phone: 646-653-0620
  • Fax: 646-653-0622
Mailing address:
  • Phone: 646-653-0620
  • Fax: 646-653-0622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GISELLE ANTOINE
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 646-653-0620