MEDICARE: LITTLE EARS THERAPY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1255768081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE EARS THERAPY CENTER

Provider Business Mailing Address
First Line	:	13840 ROSECRANS AVE
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-5208
Country	:	US
Telephone Number	:	562-926-3334
Fax Number	:	562-802-3785

Provider Business Practice Location Address
First Line	:	13840 ROSECRANS AVE
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-5208
Country	:	US
Telephone Number	:	562-926-3334
Fax Number	:	562-802-3785

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LESLIE A SIERRA GUZMAN
Credential	:
Telephone Number	:	562-926-3334

Provider Enumeration Date	:	10/11/2013
Last Update Date	:	10/11/2013

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Directions to “LITTLE EARS THERAPY CENTER ” Practice Location

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