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General NPI Number Information
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NPI Number | 1003146127
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Entity Type | Organization
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Legal Business Name | LITTLE STEPS PEDIATRIC THERAPY, INC.
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 9020 WILLOWBROOK CIR
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City | BRADENTON
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State | FL
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Zip | 34212-6332
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Country | US
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Telephone | 315-794-1742
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Fax |
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Provider Business Mailing Address
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Address Line | 9020 WILLOWBROOK CIR
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City | BRADENTON
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State | FL
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Zip | 34212-6332
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Country | US
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Telephone | 315-794-1742
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. JANELLE COLLEEN CLARKIN
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Credential | PT, DPT
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Telephone | 315-794-1742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT 24671
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License Number State | FL
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