Healthcare Provider Details

I. General information

NPI: 1033045117
Provider Name (Legal Business Name): LITTLE WAVES SPEECH & AAC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WINDING WAY
HAMMONTON NJ
08037
US

IV. Provider business mailing address

108 WINDING WAY
HAMMONTON NJ
08037
US

V. Phone/Fax

Practice location:
  • Phone: 609-226-8418
  • Fax:
Mailing address:
  • Phone: 609-226-8418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JENNIE FIAMINGO
Title or Position: OWNER/SPEECH-LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP/L
Phone: 609-226-8418