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Organization

LITTLE AND ASSOCIATES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL HOWARD DAY (GENERAL MANAGER)
(662) 510-3986
Entity
Organization

Contact information

Practice address
8830 CENTRE ST, SUITE 5, SOUTHAVEN, MS 38671-2609
(662) 510-3986
(662) 510-3988
Mailing address
8830 CENTRE ST, SUITE 5, SOUTHAVEN, MS 38671-2609
(662) 510-3986
(662) 510-3988

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31-465
MS
103TC0700X
Clinical Psychologist
P0000001384
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00114932
MS
01
510G700396
MEDICARE - LA PTAN
01
512I680050
MEDICARE - LA MLH PTAN
01
680000164
MEDICARE PTEN
MS
Enumeration date
08/18/2008
Last updated
11/26/2008
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