Healthcare Provider Details

I. General information

NPI: 1003925090
Provider Name (Legal Business Name): STEP BY STEP PEDIATRIC THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14527 PICKET OAKS RD
CENTREVILLE VA
20121-2358
US

IV. Provider business mailing address

14527 PICKET OAKS RD
CENTREVILLE VA
20121-2358
US

V. Phone/Fax

Practice location:
  • Phone: 703-222-2421
  • Fax: 703-222-2421
Mailing address:
  • Phone: 703-222-2421
  • Fax: 703-222-2421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305002352
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2305003415
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2305006066
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2305006282
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119001613
License Number StateVA
# 6
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119000749
License Number StateVA

VIII. Authorized Official

Name: MRS. BONNIE KANDEL
Title or Position: PRESIDENT/ PHYSICAL THERAPIST
Credential:
Phone: 703-222-2421