Provider Demographics
NPI:1447673272
Name:LITTLE, LEE ANNE (LMT)
Entity type:Individual
Prefix:MRS
First Name:LEE
Middle Name:ANNE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 SCARLET OAK CT
Mailing Address - Street 2:
Mailing Address - City:WOODSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21798-8341
Mailing Address - Country:US
Mailing Address - Phone:301-514-9888
Mailing Address - Fax:
Practice Address - Street 1:8701 ANTIETAM DR
Practice Address - Street 2:
Practice Address - City:WALKERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21793-8020
Practice Address - Country:US
Practice Address - Phone:301-514-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM04391225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist