Provider Demographics
NPI:1629593330
Name:LITTLE, MEGAN (BCBA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305 EAST DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-3529
Mailing Address - Country:US
Mailing Address - Phone:562-652-9134
Mailing Address - Fax:
Practice Address - Street 1:5305 EAST DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-3529
Practice Address - Country:US
Practice Address - Phone:562-652-9134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-26748103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst