Provider Demographics
NPI:1609002211
Name:LITTLE, ELISSA S (MPH, BS)
Entity Type:Individual
Prefix:MRS
First Name:ELISSA
Middle Name:S
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MPH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 57TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2949
Mailing Address - Country:US
Mailing Address - Phone:970-378-6908
Mailing Address - Fax:
Practice Address - Street 1:514 57TH AVENUE CT
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2949
Practice Address - Country:US
Practice Address - Phone:970-378-6908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health