Provider Demographics
NPI:1992916795
Name:LITTLEWOOD, PAGE JONES
Entity type:Individual
Prefix:
First Name:PAGE
Middle Name:JONES
Last Name:LITTLEWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 WESTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5072
Mailing Address - Country:US
Mailing Address - Phone:919-308-5753
Mailing Address - Fax:919-967-0515
Practice Address - Street 1:109 CONNER DRIVE
Practice Address - Street 2:SUITE 107
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:919-967-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1291106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist