Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 06-39P | AR |
Y | 103TC0700X | Clinical Psychologist | 06-39P | AR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 34329 | TX |
NPI | 1043410608 |
---|---|
Provider Name | Dr. Kelly Pizzitola Jarratt |
First Address | Little Rock, AR 72202-3500 |
Second Address | Little Rock, AR 72202-3500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 27/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164708719 | (05) | AR |