Provider Demographics
NPI:1265749162
Name:LITTLE, SHERRIE CHAPMAN (MA)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:CHAPMAN
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 DELTONA BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-8016
Mailing Address - Country:US
Mailing Address - Phone:386-473-4566
Mailing Address - Fax:386-753-9265
Practice Address - Street 1:517 DELTONA BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-8016
Practice Address - Country:US
Practice Address - Phone:386-473-4566
Practice Address - Fax:386-753-9265
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health