Provider Demographics
NPI:1962089623
Name:ONE STEP FORWARD-UN PASO HACIA ADELANTE
Entity type:Organization
Organization Name:ONE STEP FORWARD-UN PASO HACIA ADELANTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:POU
Authorized Official - Last Name:ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-456-8574
Mailing Address - Street 1:9703 S DIXIE HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2812
Mailing Address - Country:US
Mailing Address - Phone:305-456-8574
Mailing Address - Fax:
Practice Address - Street 1:9703 S DIXIE HWY STE 105
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-2812
Practice Address - Country:US
Practice Address - Phone:305-456-8574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLLICENSEOtherMH11190