Healthcare Provider Details

I. General information

NPI: 1841675121
Provider Name (Legal Business Name): MARIANNE LOTITO MS, LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 CARTI WAY STE 202
LITTLE ROCK AR
72205-6523
US

IV. Provider business mailing address

8901 CARTI WAY STE 202
LITTLE ROCK AR
72205-6523
US

V. Phone/Fax

Practice location:
  • Phone: 501-906-3000
  • Fax:
Mailing address:
  • Phone: 501-906-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGT60370582
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: