| Organization Name: | LITTLE KIDS SPEECH THERAPY, INC. |
| NPI Number: | 1427240837 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARCY ATIA RAK (OWNER/PRESIDENT) |
| Mailing Address: | 500 Copper Bend Rd Maryville |
| State: | IL US |
| Postal Code: | 620625688 |
| Phone Number: | 6187923503 |
| Fax Number: | 6182889276 |
| NPI Enumeration Date: | 08/10/2007 |
| NPI Last Update Date: | 08/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |