Individual
DANIEL LITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3764 SILVERTON STREET, BOULDER, CO 80301
(757) 342-2375
Mailing address
670 TOWN CENTER DR UNIT 416, NEWPORT NEWS, VA 23606-4474
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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