Organization
LITTLE SQUIRTS THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE PAYNE (CREDENTIALING MANAGER)
(435) 999-0912
Entity
Organization
Contact information
Practice address
169 N GATEWAY DR STE 210, PROVIDENCE, UT 84332-9805
(435) 701-7010
(435) 701-7012
Mailing address
1392 W 6500 S, HYRUM, UT 84319-7105
(435) 999-0912
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/18/2023
Last updated
02/26/2024
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