Provider Demographics
NPI:1932520715
Name:FIRST STEP PROVIDER
Entity type:Organization
Organization Name:FIRST STEP PROVIDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:606-662-4996
Mailing Address - Street 1:PO BOX 1056
Mailing Address - Street 2:
Mailing Address - City:CAMPTON
Mailing Address - State:KY
Mailing Address - Zip Code:41301-1056
Mailing Address - Country:US
Mailing Address - Phone:606-662-4996
Mailing Address - Fax:
Practice Address - Street 1:50 LAWSON SUBDIVISION
Practice Address - Street 2:
Practice Address - City:CAMPTON
Practice Address - State:KY
Practice Address - Zip Code:41301
Practice Address - Country:US
Practice Address - Phone:606-662-4996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R1324174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty