Healthcare Provider Details

I. General information

NPI: 1043105778
Provider Name (Legal Business Name): LITTLE SNACKERS THERAPEUTIC PROGRAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 LONG POND RD
PLYMOUTH MA
02360-2663
US

IV. Provider business mailing address

11 LAKEWOOD DR
PLYMOUTH MA
02360-1993
US

V. Phone/Fax

Practice location:
  • Phone: 774-454-9481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. SAMANTHA NICOLE DEAN
Title or Position: PRACTICE OWNER
Credential: MS, OTR/L
Phone: 774-454-9481