Provider Demographics
NPI:1922725761
Name:LITTLE, MARIEL ALLISON (DPT)
Entity Type:Individual
Prefix:DR
First Name:MARIEL
Middle Name:ALLISON
Last Name:LITTLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 S CODY ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-5226
Mailing Address - Country:US
Mailing Address - Phone:248-361-1108
Mailing Address - Fax:
Practice Address - Street 1:1430 S CODY ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-5226
Practice Address - Country:US
Practice Address - Phone:248-361-1108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016773225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist