MEDICARE: LITTLE CLOUD CLIMBERS LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1578396248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE CLOUD CLIMBERS LLC

Provider Business Mailing Address
First Line	:	3235 SATELLITE BLVD STE 300
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-8688
Country	:	US
Telephone Number	:	470-499-7335
Fax Number	:

Provider Business Practice Location Address
First Line	:	3235 SATELLITE BLVD STE 300
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-8688
Country	:	US
Telephone Number	:	470-499-7335
Fax Number	:

Authorized Official
Title or Position	:	BCBA
Name	:	APRYL LAMASTER
Credential	:
Telephone Number	:	470-499-7335

Provider Enumeration Date	:	08/20/2024
Last Update Date	:	09/28/2024

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