Provider Demographics
NPI:1780963652
Name:LITTLE, CARISSA LYNN (SLP)
Entity type:Individual
Prefix:MS
First Name:CARISSA
Middle Name:LYNN
Last Name:LITTLE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:474 BLACK FEATHER LOOP APT 420
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-8007
Mailing Address - Country:US
Mailing Address - Phone:406-490-7310
Mailing Address - Fax:
Practice Address - Street 1:5600 S QUEBEC ST STE 107A
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2201
Practice Address - Country:US
Practice Address - Phone:303-731-3326
Practice Address - Fax:303-647-3753
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist