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General NPI Number Information
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NPI Number | 1962209585
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Entity Type | Organization
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Legal Business Name | BOLD STEPS THERAPY & SUPPORT INC
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Dates
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Enumeration Date | 03/01/2025
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Last Update Date | 03/01/2025
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Provider Practice Location Address
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Address Line | 2103 COUNTY ROAD D E UNIT A
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City | MAPLEWOOD
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State | MN
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Zip | 55109-5357
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Country | US
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Telephone | 651-417-4341
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Fax |
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Provider Business Mailing Address
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Address Line | 2103 COUNTY ROAD D E UNIT A
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City | MAPLEWOOD
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State | MN
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Zip | 55109-5357
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AHMED AHMED
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Credential |
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Telephone | 651-417-4341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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