Healthcare Provider Details

I. General information

NPI: 1508671934
Provider Name (Legal Business Name): LITTLE FEET THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 H ST NW STE 200
WASHINGTON DC
20005-4706
US

IV. Provider business mailing address

1331 H ST NW STE 200
WASHINGTON DC
20005-4706
US

V. Phone/Fax

Practice location:
  • Phone: 301-857-9599
  • Fax:
Mailing address:
  • Phone: 301-857-9599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAWN LEIS
Title or Position: OWNER
Credential:
Phone: 301-857-9599