Organization
A STEP AHEAD PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA RODGERS (OFFICE MANAGER)
(812) 314-2378
Entity
Organization
Contact information
Practice address
2625 FOXPOINTE DRIVE, COLUMBUS, IN 47203-3278
(812) 314-2378
(812) 373-7616
Mailing address
2625 FOXPOINTE DRIVE, COLUMBUS, IN 47203-3278
(812) 314-2378
(812) 373-7616
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103K00000X
Behavior Analyst
1-12-11909
IN
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201226450
—
IN
Enumeration date
12/07/2006
Last updated
06/23/2014
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