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General NPI Number Information
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NPI Number | 1194583542
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Entity Type | Organization
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Legal Business Name | STEP TIME, INC.
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Dates
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Enumeration Date | 03/11/2024
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 2984 TRIVERTON PIKE DR STE 101
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City | FITCHBURG
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State | WI
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Zip | 53711-5841
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Country | US
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Telephone | 160-833-8354
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Fax |
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Provider Business Mailing Address
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Address Line | 2984 TRIVERTON PIKE DR STE 101
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City | FITCHBURG
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State | WI
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Zip | 53711-5841
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Country | US
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Telephone | 608-286-1037
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACI LAMB
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Credential |
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Telephone | 608-712-2362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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