Provider Demographics
NPI:1871075523
Name:LITTLE, FABIOLA ALCALA (NBCOT)
Entity type:Individual
Prefix:
First Name:FABIOLA
Middle Name:ALCALA
Last Name:LITTLE
Suffix:
Gender:F
Credentials:NBCOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 OLD HUNTS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-6811
Mailing Address - Country:US
Mailing Address - Phone:907-444-7070
Mailing Address - Fax:
Practice Address - Street 1:343 PRADO WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6512
Practice Address - Country:US
Practice Address - Phone:864-270-8647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK134955225X00000X
SC6906225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist