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General NPI Number Information
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NPI Number | 1205477239
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Entity Type | Organization
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Legal Business Name | LITTLE WONDERZ LLC
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 10598 ORANGE BLOSSOM LN
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City | SEMINOLE
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State | FL
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Zip | 33772-7503
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Country | US
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Telephone | 727-483-1861
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Fax | 727-258-4640
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Provider Business Mailing Address
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Address Line | 10623 ROSEWOOD CT N
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City | PINELLAS PARK
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State | FL
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Zip | 33782-2719
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Country | US
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Telephone | 727-458-0246
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Fax | 727-258-4640
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Authorized Official
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Title or Position | VP
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Name | MS. MARIA STEFAN
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Credential | ITDS
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Telephone | 727-458-0246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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