Healthcare Provider Details

I. General information

NPI: 1528827623
Provider Name (Legal Business Name): LITTLE WAY SPEECH & LANGUAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5025 NW 10TH ST
LINCOLN NE
68521-5338
US

IV. Provider business mailing address

5025 NW 10TH ST
LINCOLN NE
68521-5338
US

V. Phone/Fax

Practice location:
  • Phone: 402-202-1122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARITA DOTY
Title or Position: OWNER
Credential:
Phone: 402-202-1122