Provider Demographics
NPI:1609393123
Name:LITTON, ELENA JO
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:JO
Last Name:LITTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:JO
Other - Last Name:HOLZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6130 HAWKINS WAY
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89061-7945
Mailing Address - Country:US
Mailing Address - Phone:602-502-9266
Mailing Address - Fax:
Practice Address - Street 1:1731 S. HIGHWAY #160
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:775-209-9213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor