Provider Demographics
NPI:1669110268
Name:LITTLE MITTENS AUTISM CENTER PC
Entity type:Organization
Organization Name:LITTLE MITTENS AUTISM CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:248-505-0948
Mailing Address - Street 1:2278 FAIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-3932
Mailing Address - Country:US
Mailing Address - Phone:248-505-0948
Mailing Address - Fax:
Practice Address - Street 1:2278 FAIRPORT RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-3932
Practice Address - Country:US
Practice Address - Phone:248-505-0948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty