Healthcare Provider Details
I. General information
NPI: 1982597167
Provider Name (Legal Business Name): LITTLE STAR THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CALLE DIOSDADO DONES ESQ. ROOSEVELT #117 COMUNIDAD COCO
SALINAS PR
00751
US
IV. Provider business mailing address
PO BOX 682
GUAYAMA PR
00785-0682
US
V. Phone/Fax
- Phone: 787-482-4164
- Fax:
- Phone: 787-482-4164
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224Z00000X |
| Taxonomy | Occupational Therapy Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORENA
RAMOS
Title or Position: DIRECTORA
Credential:
Phone: 939-280-0110