Provider Demographics
NPI:1548955578
Name:LITTLER, NICCI JO (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:NICCI
Middle Name:JO
Last Name:LITTLER
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 1:10932 W 600 S
Mailing Address - Street 2:
Mailing Address - City:REDKEY
Mailing Address - State:IN
Mailing Address - Zip Code:47373-9352
Mailing Address - Country:US
Mailing Address - Phone:765-209-2537
Mailing Address - Fax:
Practice Address - Street 1:10932 W 600 S
Practice Address - Street 2:
Practice Address - City:REDKEY
Practice Address - State:IN
Practice Address - Zip Code:47373-9352
Practice Address - Country:US
Practice Address - Phone:765-209-2537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist