Basic Information
| Provider Information | |||||||||
| NPI: | 1003138827 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LITTLE | ||||||||
| FirstName: | TERRI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2121 MEADOWLARK RD | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN | ||||||||
| State: | KS | ||||||||
| PostalCode: | 665024556 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2121 MEADOWLARK RD | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN | ||||||||
| State: | KS | ||||||||
| PostalCode: | 665024556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7854589784 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2010 | ||||||||
| LastUpdateDate: | 02/20/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 17-0458 | KS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.