Healthcare Provider Details

I. General information

NPI: 1407224314
Provider Name (Legal Business Name): NATASHA NICOLE LITTLE-HARRISON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATASHA NICOLE LITTLE

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13821 VILLAGE MILL DR SUITE B
MIDLOTHIAN VA
23114-4314
US

IV. Provider business mailing address

13821 VILLAGE MILL DR SUITE B
MIDLOTHIAN VA
23114-4314
US

V. Phone/Fax

Practice location:
  • Phone: 804-794-8900
  • Fax: 804-378-2012
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810005248
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: