Healthcare Provider Details

I. General information

NPI: 1407349772
Provider Name (Legal Business Name): LITTLE VOICES SPEECH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 06/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 FOX RUN DR
LITTLE ROCK AR
72210-7133
US

IV. Provider business mailing address

12 FOX RUN DR
LITTLE ROCK AR
72210-7133
US

V. Phone/Fax

Practice location:
  • Phone: 501-765-7951
  • Fax:
Mailing address:
  • Phone: 501-765-7951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224ZE0001X
TaxonomyEnvironmental Modification Occupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. LACRETIA BRUCE
Title or Position: OWNER
Credential:
Phone: 501-765-7951