MEDICARE: CARRIE ANN LITTLEFIELD M.A.CCCSLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7101001717	MI

General Provider Information

NPI Number	:	1528203148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE ANN LITTLEFIELD M.A.CCCSLP

Provider Business Mailing Address
First Line	:	14145 SIMONE DR
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48315-3228
Country	:	US
Telephone Number	:	586-566-6280
Fax Number	:	586-566-1898

Provider Business Practice Location Address
First Line	:	51495 PROMENADE LN
Second Line	:
City	:	NEW BALTIMORE
State	:	MI
Zip	:	48047-6517
Country	:	US
Telephone Number	:	586-747-4606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2008
Last Update Date	:	04/05/2017

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