Organization
A STEP FORWARD L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LELAND BOYD KORB (MEMBER)
(307) 436-9304
Entity
Organization
Contact information
Practice address
506 WEST BIRCH, SUITE 14, GLENROCK, WY 82637
(307) 436-8080
Mailing address
P.O. BOX 1255, GLENROCK, WY 82637-1255
(307) 436-8080
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAT-291
WY
101YP2500X
Professional Counselor
Primary
LPC-391
WY
103TC0700X
Clinical Psychologist
—
—
Other
Enumeration date
09/30/2010
Last updated
04/11/2013
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