Provider Demographics
NPI:1164300620
Name:BIG STRIDE THERAPY
Entity type:Organization
Organization Name:BIG STRIDE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEWIT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:678-665-2926
Mailing Address - Street 1:150 FOAL DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3511
Mailing Address - Country:US
Mailing Address - Phone:678-665-2926
Mailing Address - Fax:
Practice Address - Street 1:2755 BUNTEN RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4003
Practice Address - Country:US
Practice Address - Phone:678-665-2926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-23
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty