Provider Demographics
NPI:1386412161
Name:STEAM EARLY INTERVENTIONS AND THERAPY
Entity type:Organization
Organization Name:STEAM EARLY INTERVENTIONS AND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CENTER DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YRALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVEREUX
Authorized Official - Suffix:
Authorized Official - Credentials:ITDS, RBT
Authorized Official - Phone:208-695-0098
Mailing Address - Street 1:5301 GODDARD AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-5437
Mailing Address - Country:US
Mailing Address - Phone:407-440-8193
Mailing Address - Fax:
Practice Address - Street 1:5301 GODDARD AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-5437
Practice Address - Country:US
Practice Address - Phone:407-440-8193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty