Provider Demographics
NPI:1235478496
Name:LITTLETON, BRENDA JEAN (MA MFT-T)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:JEAN
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:MA MFT-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 513
Mailing Address - Street 2:
Mailing Address - City:JOSHUA TREE
Mailing Address - State:CA
Mailing Address - Zip Code:92252-0513
Mailing Address - Country:US
Mailing Address - Phone:909-645-3046
Mailing Address - Fax:
Practice Address - Street 1:58945 BUSINESS CENTER DR SUITE D
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-7307
Practice Address - Country:US
Practice Address - Phone:760-228-9657
Practice Address - Fax:760-369-6758
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor