Provider Demographics
NPI:1407239908
Name:LITTEBRANT, LOIS EILEEN (LBSW)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:EILEEN
Last Name:LITTEBRANT
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N HIGBY ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-4018
Mailing Address - Country:US
Mailing Address - Phone:517-414-8328
Mailing Address - Fax:517-254-4458
Practice Address - Street 1:119 N HIGBY ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-4018
Practice Address - Country:US
Practice Address - Phone:517-414-8328
Practice Address - Fax:517-254-4458
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802075239104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker