Provider Demographics
NPI:1972745446
Name:LITTLE, VANESSA P
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:P
Last Name:LITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:VANESSA
Other - Middle Name:P
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:TRANSITIONAL CASE MA
Mailing Address - Street 1:3410 HEALY DR
Mailing Address - Street 2:SUITE # 211
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1403
Mailing Address - Country:US
Mailing Address - Phone:336-765-0735
Mailing Address - Fax:336-765-0736
Practice Address - Street 1:3410 HEALY DR
Practice Address - Street 2:SUITE # 211
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1403
Practice Address - Country:US
Practice Address - Phone:336-765-0735
Practice Address - Fax:336-765-0736
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator