Provider Demographics
NPI:1306628250
Name:LITTLE, JANICE (DM)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:DM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15500 VOSS RD # 321
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-4601
Mailing Address - Country:US
Mailing Address - Phone:832-604-3616
Mailing Address - Fax:
Practice Address - Street 1:15500 VOSS RD # 321
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4601
Practice Address - Country:US
Practice Address - Phone:832-604-3616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21646104100000X, 1041S0200X
TX12609542172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No172A00000XOther Service ProvidersDriver