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General NPI Number Information
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NPI Number | 1568325876
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Entity Type | Organization
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Legal Business Name | LITTLE SPARK ABA
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 47 BUCKINGHAM ST
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City | WATERBURY
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State | CT
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Zip | 06710-1900
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Country | US
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Telephone | 860-631-3442
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Fax |
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Provider Business Mailing Address
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Address Line | 52 BLUERIDGE DRIVE EXT
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City | WATERBURY
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State | CT
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Zip | 06704-6121
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Country | US
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Telephone | 860-631-3442
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | SHULAMIT FELD
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Credential | BCBA
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Telephone | 203-768-0250
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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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