Provider Demographics
NPI:1508207796
Name:STEP-BY-STEP FAMILY THERAPY A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:STEP-BY-STEP FAMILY THERAPY A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:307-221-3707
Mailing Address - Street 1:2404 KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-8937
Mailing Address - Country:US
Mailing Address - Phone:307-221-3707
Mailing Address - Fax:307-742-6675
Practice Address - Street 1:2020 E GRAND AVE STE 400
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-4388
Practice Address - Country:US
Practice Address - Phone:307-221-3707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty