Provider Demographics
NPI:1134713720
Name:LITTLE, TARSAE YEVETTE
Entity type:Individual
Prefix:
First Name:TARSAE
Middle Name:YEVETTE
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 1:8400 VETERANS PKWY APT 1824
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2497
Mailing Address - Country:US
Mailing Address - Phone:706-358-8713
Mailing Address - Fax:
Practice Address - Street 1:8400 VETERANS PKWY APT 1824
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-2497
Practice Address - Country:US
Practice Address - Phone:706-358-8713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management