Provider Demographics
NPI:1336397504
Name:LITTLEFIELD, ALISHA M (LMT,NMT)
Entity type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:M
Last Name:LITTLEFIELD
Suffix:
Gender:F
Credentials:LMT,NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 DANTE PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8418
Mailing Address - Country:US
Mailing Address - Phone:904-348-5511
Mailing Address - Fax:904-348-6601
Practice Address - Street 1:917 DANTE PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8418
Practice Address - Country:US
Practice Address - Phone:904-348-5511
Practice Address - Fax:904-348-6601
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA44590225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist