Healthcare Provider Details

I. General information

NPI: 1295646396
Provider Name (Legal Business Name): LITTLE WILD ONES THERAPY & PLAYHOUSE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W MAIN ST
PARSONS TN
38363-2018
US

IV. Provider business mailing address

211 W MAIN ST
PARSONS TN
38363-2018
US

V. Phone/Fax

Practice location:
  • Phone: 731-847-7000
  • Fax:
Mailing address:
  • Phone: 731-549-6226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHELLE WYATT
Title or Position: ADMINISTRATOR/BUSINESS MANAGER
Credential:
Phone: 731-549-6226