Provider Demographics
NPI:1063613867
Name:LYTTLE FOX THERAPY
Entity type:Organization
Organization Name:LYTTLE FOX THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:D
Authorized Official - Last Name:LYTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:615-758-4888
Mailing Address - Street 1:3580 N MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3061
Mailing Address - Country:US
Mailing Address - Phone:615-758-4888
Mailing Address - Fax:615-758-6188
Practice Address - Street 1:3580 N MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3061
Practice Address - Country:US
Practice Address - Phone:615-758-4888
Practice Address - Fax:615-758-6188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities