=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750826855
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEP BY STEP RESOURCES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2016
-----------------------------------------------------
Last Update Date | 12/27/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 S SPRING ST STE 220
-----------------------------------------------------
City | LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72201-2444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-772-3991
-----------------------------------------------------
Fax | 501-565-0549
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 S SPRING ST STE 220
-----------------------------------------------------
City | LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72201-2444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-772-3991
-----------------------------------------------------
Fax | 501-565-0549
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | NINA SUE WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 501-772-3991
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------