=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912030289
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIRST STEPS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2563 E COLONIAL AVE
-----------------------------------------------------
City | TERRE HAUTE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47805-2601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-466-9509
-----------------------------------------------------
Fax | 812-466-9870
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2563 E COLONIAL AVE
-----------------------------------------------------
City | TERRE HAUTE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47805-2601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-466-9509
-----------------------------------------------------
Fax | 812-466-9870
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DEVELOPMENTAL THERAPY SPECIALIST
-----------------------------------------------------
Name | MRS. JAIMEE P DUGGER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 812-201-6583
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 373H00000X
-----------------------------------------------------
Taxonomy Name | Day Training/Habilitation Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------