Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 7083832-3502 | UT |
NPI | 1003124314 |
---|---|
Provider Name | Mrs. Varonica Lyn Little |
First Address | Kearns, UT 84118-3725 |
Second Address | Kearns, UT 84118-3725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2010 |
Last Update Date | 21/09/2010 |