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General NPI Number Information
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NPI Number | 1003385410
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Entity Type | Individual
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Provider Name | KARYNTHIA TACHIANA LITTLE
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Gender | Female
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 251 W 84TH DR
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6243
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Country | US
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Telephone | 219-295-3463
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Fax | 317-520-8200
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Provider Business Mailing Address
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Address Line | 14052 WHIPPLE ST
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City | BLUE ISLAND
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State | IL
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Zip | 60406-3385
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Country | US
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Telephone | 708-400-5907
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-76958
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License Number State | IN
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