=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255650818
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LITTLE VOICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2010
-----------------------------------------------------
Last Update Date | 05/21/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 756 TWILIGHT DR
-----------------------------------------------------
City | CRESCENT SPRINGS
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41017-4485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-331-8305
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 756 TWILIGHT DR
-----------------------------------------------------
City | CRESCENT SPRINGS
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41017-4485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-331-8305
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SLP
-----------------------------------------------------
Name | ANNE GAUNDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 859-331-8305
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 1496
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------