Provider Demographics
NPI:1750663548
Name:LITTLE, CYNTHIA J
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:J
Last Name:LITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 E CENTENNIAL PKWY APT 2094
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1371
Mailing Address - Country:US
Mailing Address - Phone:702-572-2804
Mailing Address - Fax:
Practice Address - Street 1:245 E CENTENNIAL PKWY APT 2094
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-1371
Practice Address - Country:US
Practice Address - Phone:702-572-2804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner