Provider Demographics
NPI:1881387348
Name:LITTLE WONDERS SPECTRUM THERAPY LLC
Entity type:Organization
Organization Name:LITTLE WONDERS SPECTRUM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SANTANU
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-762-1060
Mailing Address - Street 1:3381 BERKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 CYPRESS BEND PKWY STE B2
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:TX
Practice Address - Zip Code:75407-1030
Practice Address - Country:US
Practice Address - Phone:469-936-0060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty