Healthcare Provider Details

I. General information

NPI: 1730493271
Provider Name (Legal Business Name): LITTLE ANGELS THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 12TH AVE NE
HICKORY NC
28601-3187
US

IV. Provider business mailing address

21 RIVER TERRACE CT
TAYLORSVILLE NC
28681-3920
US

V. Phone/Fax

Practice location:
  • Phone: 828-578-6028
  • Fax: 855-767-7030
Mailing address:
  • Phone: 828-302-2055
  • Fax: 828-495-7700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberP-7142
License Number StateNC

VIII. Authorized Official

Name: MR. THOMAS DOYLE FORD
Title or Position: VICE PRESIDENT
Credential: PTA
Phone: 828-302-2056