Provider Demographics
NPI:1265315204
Name:LITTLE WAVES SPEECH THERAPY LLC
Entity type:Organization
Organization Name:LITTLE WAVES SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-556-7169
Mailing Address - Street 1:346 ILIMALIA LOOP
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1851
Mailing Address - Country:US
Mailing Address - Phone:702-556-7169
Mailing Address - Fax:
Practice Address - Street 1:346 ILIMALIA LOOP
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1851
Practice Address - Country:US
Practice Address - Phone:702-556-7169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care