Individual
JEFFERY BRENT LITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
545 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3389
(678) 377-2833
(678) 377-2882
Mailing address
2704 RICE MILL CT, GRAYSON, GA 30017-4047
(678) 407-0764
(678) 377-2882
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT003324
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000903009C
—
GA
Enumeration date
01/29/2007
Last updated
10/05/2010
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