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General NPI Number Information
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NPI Number | 1508207796
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Entity Type | Organization
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Legal Business Name | STEP-BY-STEP FAMILY THERAPY A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/16/2013
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 2020 E GRAND AVE STE 400
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City | LARAMIE
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State | WY
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Zip | 82070-4388
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Country | US
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Telephone | 307-221-3707
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Fax |
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Provider Business Mailing Address
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Address Line | 2404 KNOLL CT
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City | LARAMIE
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State | WY
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Zip | 82070-8937
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Country | US
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Telephone | 307-221-3707
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Fax | 307-742-6675
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. VICKI A MARTIN
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Credential | LMFT
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Telephone | 307-221-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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