Provider Demographics
NPI:1114750569
Name:LITTLETON, KENDALL HINST
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:HINST
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:SHAE
Other - Last Name:HINST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4304 LONG HOLLOW PIKE UNIT C
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-8807
Mailing Address - Country:US
Mailing Address - Phone:615-613-3612
Mailing Address - Fax:
Practice Address - Street 1:111 IMPERIAL BLVD STE E
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3400
Practice Address - Country:US
Practice Address - Phone:615-560-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician