MEDICARE: KATHRYN P LITTLETON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	1756	SC

General Provider Information

NPI Number	:	1073550240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN P LITTLETON

Provider Business Mailing Address
First Line	:	160 KINGSBRIDGE DR
Second Line	:
City	:	GOOSE CREEK
State	:	SC
Zip	:	29445-6645
Country	:	US
Telephone Number	:	843-761-8282
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 STONEY LANDING RD
Second Line	:
City	:	MONCKS CORNER
State	:	SC
Zip	:	29461-3967
Country	:	US
Telephone Number	:	843-761-8282
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/08/2007

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