Individual
MS. LADEIDRA CHANTEL LITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, LMT, MMP
Contact information
Practice address
303 HARGROVE RD E, TUSCALOOSA, AL 35401-5029
(205) 377-8780
Mailing address
3104 CLAUDE JACKSON 35, ALICEVILLE, AL 35442-7061
(205) 609-7167
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5783
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740810795
1740810795
AL
Enumeration date
12/10/2021
Last updated
12/10/2021
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