Provider Demographics
NPI:1205688231
Name:LITTLE BITES THERAPY
Entity type:Organization
Organization Name:LITTLE BITES THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-971-0325
Mailing Address - Street 1:14421 S 3400 W
Mailing Address - Street 2:
Mailing Address - City:BLUFFDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84065-5429
Mailing Address - Country:US
Mailing Address - Phone:801-599-3713
Mailing Address - Fax:
Practice Address - Street 1:14421 S 3400 W
Practice Address - Street 2:
Practice Address - City:BLUFFDALE
Practice Address - State:UT
Practice Address - Zip Code:84065-5429
Practice Address - Country:US
Practice Address - Phone:801-599-3713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty