Provider Demographics
NPI:1730211681
Name:LITTLE, BROOKE (MCDCFSLP)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MCDCFSLP
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCDCFSLP
Mailing Address - Street 1:501 PINTAIL COVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:AR
Mailing Address - Zip Code:72432
Mailing Address - Country:US
Mailing Address - Phone:870-243-6247
Mailing Address - Fax:870-578-6131
Practice Address - Street 1:3423 HIGHLAND DR
Practice Address - Street 2:SUITE A
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-336-0021
Practice Address - Fax:870-336-0022
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P7912235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist