Provider Demographics
NPI:1427763994
Name:LITTLE SEEDS
Entity type:Organization
Organization Name:LITTLE SEEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:334-413-0038
Mailing Address - Street 1:6904 COUNTY ROAD 9
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:AL
Mailing Address - Zip Code:36785-5033
Mailing Address - Country:US
Mailing Address - Phone:334-413-0038
Mailing Address - Fax:334-460-0132
Practice Address - Street 1:6904 COUNTY ROAD 9
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:AL
Practice Address - Zip Code:36785-5033
Practice Address - Country:US
Practice Address - Phone:334-413-0038
Practice Address - Fax:334-460-0132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty