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General NPI Number Information
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NPI Number | 1851969265
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Entity Type | Organization
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Legal Business Name | MY LITTLE SUNSHINE THERAPY LLC
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Dates
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Enumeration Date | 06/12/2021
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Last Update Date | 06/12/2021
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Provider Practice Location Address
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Address Line | 1909 W. 3 MILE RD STE 700
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City | MISSION
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State | TX
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Zip | 78573
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Country | US
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Telephone | 956-997-0022
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Fax | 956-997-0065
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Provider Business Mailing Address
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Address Line | 78 ALA BLANCA ST
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-6628
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Country | US
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Telephone | 956-997-0022
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Fax | 956-997-0065
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Authorized Official
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Title or Position | OWNER
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Name | KARINA JOHANA TANGUMA
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Credential | SLP
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Telephone | 956-997-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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