Healthcare Provider Details
I. General information
NPI: 1184484669
Provider Name (Legal Business Name): SMALL STEPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2024
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1733 ANTHONY DR
PATRICK SPRINGS VA
24133-3593
US
IV. Provider business mailing address
1733 ANTHONY DR
PATRICK SPRINGS VA
24133-3593
US
V. Phone/Fax
- Phone: 276-229-7468
- Fax:
- Phone: 276-229-7468
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WHITNEY
ANNE
GARCIA-MATA
Title or Position: CEO
Credential: MS, BCBA, LBA
Phone: 276-229-7468