NPI 1104869528

Kenneth B. Little, MA

Practitioner Psychologist Roseville, MN

Practice location

Address: 1935 County Road B2 W STE 120, Roseville, MN 55113-2722
Phone: (651) 964-0235
Fax: (651) 340-5652
Mailing address: 5505 Interlachen Blvd, Edina, MN 55436-1322

Registered specialties

Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence LP0568 (MN)

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Registry record

NPI: 1104869528
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Jun 2006
Record last updated: 19 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.