Provider Demographics
NPI:1316665573
Name:LITTLEHALES, ERICA MICHELLE PROUD (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:MICHELLE PROUD
Last Name:LITTLEHALES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 HARRISON LN
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-1929
Mailing Address - Country:US
Mailing Address - Phone:940-464-0564
Mailing Address - Fax:
Practice Address - Street 1:1050 HARRISON LN
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-1929
Practice Address - Country:US
Practice Address - Phone:940-464-0564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100921235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty