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General NPI Number Information
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NPI Number | 1588531206
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Entity Type | Organization
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Legal Business Name | SEA STEPS PEDIATRIC THERAPY
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 100 TIMBER TRAIL RD
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City | RICHMOND HILL
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State | GA
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Zip | 31324-9415
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Country | US
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Telephone | 912-803-0679
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Fax |
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Provider Business Mailing Address
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Address Line | 99 WAVERLY LN
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City | RICHMOND HILL
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State | GA
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Zip | 31324-7805
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Country | US
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Telephone | 404-803-0679
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | GINA HALDEMAN
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Credential | PT, DPT
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Telephone | 404-803-0679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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