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General NPI Number Information
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NPI Number | 1063895837
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Entity Type | Individual
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Provider Name | JANNA WILLIAMS-PITTS PHD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 3805 CHEROKEE ST NW
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City | KENNESAW
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State | GA
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Zip | 30144-2085
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Country | US
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Telephone | 470-956-3950
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Fax | 770-565-1830
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Provider Business Mailing Address
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Address Line | 805 SANDY PLAINS ROAD MEDICAL STAFF SERVICES
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City | MARIETTA
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State | GA
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Zip | 30066-6340
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 20042863A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY004158
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License Number State | GA
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