Provider Demographics
NPI:1881715407
Name:LITTLTEON, DOROTHA JANE (LPC, CDC II)
Entity type:Individual
Prefix:
First Name:DOROTHA
Middle Name:JANE
Last Name:LITTLTEON
Suffix:
Gender:F
Credentials:LPC, CDC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4341
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-4341
Mailing Address - Country:US
Mailing Address - Phone:907-746-5746
Mailing Address - Fax:
Practice Address - Street 1:9061 E FRONTAGE RD STE 202
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9317
Practice Address - Country:US
Practice Address - Phone:907-746-5746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK#127101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health