Provider Demographics
NPI:1528203148
Name:LITTLEFIELD, CARRIE ANN (MACCCSLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:LITTLEFIELD
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14145 SIMONE DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3228
Mailing Address - Country:US
Mailing Address - Phone:586-566-6280
Mailing Address - Fax:586-566-1898
Practice Address - Street 1:51495 PROMENADE LN
Practice Address - Street 2:
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-6517
Practice Address - Country:US
Practice Address - Phone:586-747-4606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101001717235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist