Little Tree Pediatric Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7044 Issued in NC

Legal business name

LITTLE TREE PEDIATRIC THERAPY

Practice address

115 Linbrook Dr
Winston Salem, NC 27106-4538

Phone

(336) 774-3824

Fax

(336) 774-6579

NPI assigned

Mar 4, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Susie Fitzgerald, M.S. CCC-SLP

Title

Owner

Phone

(336) 926-0333

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1922278233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LINBROOK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064538",
            "telephone_number": "336-774-3824",
            "fax_number": "336-774-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LINBROOK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064538",
            "telephone_number": "336-774-3824",
            "fax_number": "336-774-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE TREE PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-926-0333",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jackson Lawrence Lisotta, SRNA
• Little Champions Pediatric Therapy, LLC
• Anna Bowles Little, SLP
• Brian T Little, CPO
• Brittany Savannah Little, LCSW-A
• Brittney Little
• Burnie Roy Little, PA

• Speech-Language Pathologist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.