Provider Demographics
NPI:1003033796
Name:LITTLE, LORI ANN (LLP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANN
Last Name:LITTLE
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30375 NORTHWESTERN HWY.
Mailing Address - Street 2:SUITE #200
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3297
Mailing Address - Country:US
Mailing Address - Phone:248-254-3332
Mailing Address - Fax:248-254-3333
Practice Address - Street 1:38345 W. TEN MILE RD.
Practice Address - Street 2:SUITE 150
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335
Practice Address - Country:US
Practice Address - Phone:248-722-2653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011714103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral