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General NPI Number Information
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NPI Number | 1093205692
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Entity Type | Organization
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Legal Business Name | FOOTSTEPS LLC
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 1059 HUNTINGDON AVE
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City | WATERBURY
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State | CT
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Zip | 06704-1402
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Country | US
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Telephone | 203-519-2616
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Fax |
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Provider Business Mailing Address
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Address Line | 128 HOTCHKISS AVE
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City | THOMASTON
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State | CT
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Zip | 06787-1524
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE PIZZUTO
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Credential | LPC
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Telephone | 203-519-2616
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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 |
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License Number State |
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