Provider Information for 1194809707
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Mr. TIMOTHY MARK PITTMAN LPC
Sex: Male
NPI: 1194809707
Last Updated: 2018-12-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1194809707 | ||||||||
| Enumeration Date | 2006-10-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2574 GRIFFITH MEADOWS DR. WINSTON-SALEM, NC 27103 United States Phone: 336-692-5143 | Fax:336-448-5723 | ||||||||
| Primary Practice Address | 8011 NORTH POINT BLVD STE 104 WINSTON-SALEM, NC 27106 United States Phone: 336-692-5143 | Fax:336-448-5723 | ||||||||
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