Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 112548 | TX |
N | 225XH1200X | Occupational Therapist - Hand | 17-03513 | KS |
Y | 225XH1200X | Occupational Therapist - Hand | 2019003785 | MO |
NPI | 1104194059 |
---|---|
Provider Name | Cassie Lynn Pitts |
First Address | Chattanooga, TN 37421-4915 |
Second Address | Harrisonville, MO 64701-1653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2011 |
Last Update Date | 30/04/2019 |