Andre Little
Counselor in San Rafael, CA. Individual provider (NPI-1).
NPI number1366176752
StatusActive
Last updated in NPPESJul 15, 2022
Details
- NPI
- 1366176752
- Entity type
- Individual (NPI-1)
- Name
- Andre Little
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 12, 2022
- Certification date
- Jul 15, 2022
- Last updated
- Jul 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
7 Le Claire CtSan Rafael, CA 94903-3526
Phone 415-755-3627
Mailing address
7 Le Claire CtSan Rafael, CA 94903-3526
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