Provider Demographics
NPI:1730404807
Name:LITTLE, JANICEN LYNN (MA/CCC-SLP)
Entity type:Individual
Prefix:
First Name:JANICEN
Middle Name:LYNN
Last Name:LITTLE
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 1:481 OWENS RD
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-9677
Mailing Address - Country:US
Mailing Address - Phone:318-533-8539
Mailing Address - Fax:
Practice Address - Street 1:481 OWENS RD
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:LA
Practice Address - Zip Code:71225-9677
Practice Address - Country:US
Practice Address - Phone:318-533-8539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist