Doctor Name: | MR. TIMOTHY MARK PITTMAN |
NPI Number: | 1194809707 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 5438 |
Business Practice Address: | 1045 Lowvalley Ct Rural Hall, NC - 270459647 |
Business Phone Number: | 3366925143 |
Business Fax Number: | |
Mailing Address: | 1045 Lowvalley Ct, RURAL HALL |
State: | NC |
Postal Code: | 270459647 |
Phone Number: | 3366925143 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 5438 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |