Healthcare Provider Details
I. General information
NPI: 1629365226
Provider Name (Legal Business Name): LITTLE BEHAVIOR CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2011
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4309 VISTA VERDE DR
AUSTIN TX
78732-2493
US
IV. Provider business mailing address
4309 VISTA VERDE DR
AUSTIN TX
78732-2493
US
V. Phone/Fax
- Phone: 785-760-4948
- Fax:
- Phone: 785-760-4948
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AMANDA
L
LITTLE
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: PH.D., BCBA-D
Phone: 785-760-4948