Provider Demographics
NPI:1215618657
Name:LITTLE MILESTONES SPEECH THERAPY
Entity type:Organization
Organization Name:LITTLE MILESTONES SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:ELISA
Authorized Official - Last Name:MONTIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC
Authorized Official - Phone:415-283-9813
Mailing Address - Street 1:613 JACKSON CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-8315
Mailing Address - Country:US
Mailing Address - Phone:415-283-9813
Mailing Address - Fax:
Practice Address - Street 1:613 JACKSON CT
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-8315
Practice Address - Country:US
Practice Address - Phone:415-283-9813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty