Provider Demographics
NPI:1841874773
Name:DYNAMIC STEPS THERAPY
Entity type:Organization
Organization Name:DYNAMIC STEPS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:561-537-9321
Mailing Address - Street 1:7711 N MILITARY TRL STE 205
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6506
Mailing Address - Country:US
Mailing Address - Phone:561-537-9321
Mailing Address - Fax:561-484-7194
Practice Address - Street 1:7711 N MILITARY TRL STE 205
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6506
Practice Address - Country:US
Practice Address - Phone:561-237-9321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1841874773Medicaid