Provider Demographics
NPI:1770159113
Name:LITTLE, DANIELLE (COTA/L)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 GREEN ST APT 8F
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-2476
Mailing Address - Country:US
Mailing Address - Phone:757-319-5757
Mailing Address - Fax:
Practice Address - Street 1:301 GREEN ST APT 8F
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2476
Practice Address - Country:US
Practice Address - Phone:757-319-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131000446224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant