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General NPI Number Information
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NPI Number | 1437478617
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Entity Type | Organization
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Legal Business Name | SECOND STEP
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 3010 MONTGOMERY RD
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City | HUNTSVILLE
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State | TX
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Zip | 77340-6022
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Country | US
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Telephone | 936-581-1252
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Fax |
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Provider Business Mailing Address
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Address Line | 121 BRIAR MDW
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City | HUNTSVILLE
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State | TX
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Zip | 77320-1952
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Country | US
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Telephone | 936-581-1252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT DANIEL ROBINSON
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Credential | LPC
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Telephone | 936-581-1252
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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 | 15617
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License Number State | TX
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