Provider Demographics
NPI:1609084110
Name:LITTLETON, DOLORES EVELYN (DMIN)
Entity Type:Individual
Prefix:DR
First Name:DOLORES
Middle Name:EVELYN
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HUNT CLUB LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3411
Mailing Address - Country:US
Mailing Address - Phone:610-353-1103
Mailing Address - Fax:
Practice Address - Street 1:TRINITY LUTHERAN CHURCH
Practice Address - Street 2:1141 WEST CHESTER PIKE
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083
Practice Address - Country:US
Practice Address - Phone:610-446-6398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000314106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist