Organization
FOOTSTEPS PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY K HASLETT PH.D. (OWNER)
(814) 266-5238
Entity
Organization
Contact information
Practice address
334 BLOOMFIELD ST, SUITE 104, JOHNSTOWN, PA 15904-3268
(814) 266-5238
Mailing address
334 BLOOMFIELD ST, SUITE 204, JOHNSTOWN, PA 15904-3268
(814) 266-5238
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS008994L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025765450004
—
PA
01
—
331004
BLUE CROSS/SHIELD
PA
Enumeration date
08/01/2013
Last updated
04/27/2017
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