Provider Demographics
NPI:1104451442
Name:LITTLE, ALANA D (SUDPT)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:D
Last Name:LITTLE
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:
Other - First Name:ALANA
Other - Middle Name:D
Other - Last Name:STEARNS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SUDPT
Mailing Address - Street 1:5019 GROVE ST , MARYSVILLE, WA 98270
Mailing Address - Street 2:SUITE #103A
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270
Mailing Address - Country:US
Mailing Address - Phone:360-547-9220
Mailing Address - Fax:
Practice Address - Street 1:5019 GROVE ST STE 103A
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4487
Practice Address - Country:US
Practice Address - Phone:360-631-6615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61032930101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)