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Individual

MS. DEREZMA LASHON LITTLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
QP, MA

Contact information

Practice address
7900 TRIAD CENTER DR, GREENSBORO, NC 27409-9073
(336) 931-1800
(336) 931-1802
Mailing address
3901 BATTLEGROUND AVE. APT. 30, GREENSBORO, NC 27410
(336) 931-1800
(336) 931-1801

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YM0800X
NC
Enumeration date
04/05/2011
Last updated
04/05/2011
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