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General NPI Number Information
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NPI Number | 1811146400
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Entity Type | Individual
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Provider Name | SUZANNE A.S. LITTLE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 15 W 12TH ST SUITE 1C
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City | NEW YORK
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State | NY
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Zip | 10011-8546
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Country | US
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Telephone | 212-366-5993
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Fax |
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Provider Business Mailing Address
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Address Line | 15 W 12TH ST SUITE 1C
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City | NEW YORK
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State | NY
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Zip | 10011-8546
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Country | US
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Telephone | 212-366-5993
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 014-040
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | 014-040
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License Number State | NY
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