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General NPI Number Information
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NPI Number | 1639694987
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Entity Type | Organization
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Legal Business Name | LITTLEFIELD PSYCHOLOGICAL SERVICES, INC
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 08/08/2017
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Provider Practice Location Address
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Address Line | 10451 W PALMERAS DR STE 105
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City | SUN CITY
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State | AZ
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Zip | 85373-2067
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Country | US
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Telephone | 623-695-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 16848 W BRIDLINGTON AVE
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City | SURPRISE
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State | AZ
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Zip | 85374-6865
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Country | US
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Telephone | 623-695-9700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. KENNETH WAYNE LITTLEFIELD
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Credential | PSY.D
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Telephone | 623-695-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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