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General NPI Number Information
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NPI Number | 1275081226
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Entity Type | Organization
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Legal Business Name | LITTLE KIDS ACADEMY
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 384 TRAPELO RD
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City | BELMONT
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State | MA
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Zip | 02478-1957
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Country | US
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Telephone | 617-489-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 137 SYCAMORE ST
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City | BELMONT
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State | MA
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Zip | 02478-4945
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | REIKO AKUKWE
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Credential | BCBA
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Telephone | 617-913-3849
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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 | 1-15-18067
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License Number State |
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