Healthcare Provider Details

I. General information

NPI: 1962089623
Provider Name (Legal Business Name): ONE STEP FORWARD-UN PASO HACIA ADELANTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9703 S DIXIE HWY STE 105
PINECREST FL
33156-2812
US

IV. Provider business mailing address

9703 S DIXIE HWY STE 105
PINECREST FL
33156-2812
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-8574
  • Fax:
Mailing address:
  • Phone: 305-456-8574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA POU ABREU
Title or Position: AUTHORIZED OFFICAL
Credential: LMHC
Phone: 305-456-8574