# LITTLE SQUIRTS THERAPY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518654730
- **Authorized official:** MELANIE PAYNE (CREDENTIALING MANAGER)
- **Authorized official phone:** (435) 999-0912

## Contact information

- **Practice address:** 169 N GATEWAY DR STE 210, PROVIDENCE, UT 84332-9805
- **Practice address phone:** (435) 701-7010
- **Practice address fax:** (435) 701-7012
- **Mailing address:** 1392 W 6500 S, HYRUM, UT 84319-7105
- **Mailing address phone:** (435) 999-0912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | Yes |
| 2251P0200X | Pediatric Physical Therapist | — | — | Yes |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 04/18/2023
- **Last updated:** 02/26/2024