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General NPI Number Information
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NPI Number | 1043607732
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Entity Type | Organization
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Legal Business Name | SMALL STEPS INTERNATIONAL
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 707 BROADWAY BLVD NE SUITE 103
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2360
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Country | US
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Telephone | 505-933-4639
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Fax | 505-206-5002
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Provider Business Mailing Address
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Address Line | 707 BROADWAY BLVD NE SUITE 103
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2360
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Country | US
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Telephone | 505-933-4639
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Fax | 505-206-5002
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. COURTNEY LEWIS
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Credential | LPCC
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Telephone | 505-933-4639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0109871
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License Number State | NM
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