Healthcare Provider Details

I. General information

NPI: 1497197578
Provider Name (Legal Business Name): FIRST STEPS AND BEYOND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 MARYPORT DR
WESTFIELD IN
46074-1100
US

IV. Provider business mailing address

1015 MARYPORT DR
WESTFIELD IN
46074-1100
US

V. Phone/Fax

Practice location:
  • Phone: 317-399-6149
  • Fax:
Mailing address:
  • Phone: 317-399-6149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1107564
License Number StateIN

VIII. Authorized Official

Name: SHEILA HABARAD
Title or Position: BCBA/OWNER
Credential:
Phone: 317-399-6149