Healthcare Provider Details

I. General information

NPI: 1417666033
Provider Name (Legal Business Name): A STEP AHEAD PEDIATRIC THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2022
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7134 S. YALE AVE. SUITE 710
TULSA OK
74136
US

IV. Provider business mailing address

7134 S. YALE AVE. SUITE 710
TULSA OK
74136
US

V. Phone/Fax

Practice location:
  • Phone: 918-544-6101
  • Fax: 918-600-1163
Mailing address:
  • Phone: 918-544-6101
  • Fax: 918-600-1163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. AMANDA SCOTT CAPERTON
Title or Position: CO-OWNER
Credential: PT, DPT
Phone: 918-544-6101