Provider Demographics
NPI:1164928297
Name:LITTRELL, HAZEL KAYE P (COTA/L)
Entity Type:Individual
Prefix:
First Name:HAZEL KAYE
Middle Name:P
Last Name:LITTRELL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:HAZEL KAYE
Other - Middle Name:P
Other - Last Name:PONCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:701 OAK TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3232
Mailing Address - Country:US
Mailing Address - Phone:808-561-4117
Mailing Address - Fax:
Practice Address - Street 1:701 OAK TERRACE LN
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3232
Practice Address - Country:US
Practice Address - Phone:808-561-4117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10849224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant