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General NPI Number Information
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NPI Number | 1336443134
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Entity Type | Individual
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Provider Name | CATHERINE M. LITTLE BRS
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Gender | Female
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Dates
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Enumeration Date | 01/07/2011
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 504 E 24TH ST
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City | TISHOMINGO
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State | OK
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Zip | 73460-3214
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Country | US
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Telephone | 903-815-0243
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Fax |
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Provider Business Mailing Address
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Address Line | 862 HICKS
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City | MADILL
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State | OK
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Zip | 73446-8383
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Country | US
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Telephone | 580-795-5346
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 100746580G
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License Number State | OK
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