Provider Demographics
NPI:1669606927
Name:LITTLETON, ANDREA ANNE (MED, LPC)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ANNE
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 PRIMROSE DR
Mailing Address - Street 2:APT 5B
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-1207
Mailing Address - Country:US
Mailing Address - Phone:660-728-2373
Mailing Address - Fax:
Practice Address - Street 1:2301 PRIMROSE DR
Practice Address - Street 2:APT 5B
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1207
Practice Address - Country:US
Practice Address - Phone:660-728-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005038670101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional