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General NPI Number Information
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NPI Number | 1124143763
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Entity Type | Organization
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Legal Business Name | MICHAEL PITTS, PSY.D., P.C.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 70 MANSELL CT SUITE 100
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City | ROSWELL
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State | GA
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Zip | 30076-1523
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Country | US
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Telephone | 770-594-8003
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Fax |
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Provider Business Mailing Address
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Address Line | 70 MANSELL CT SUITE 100
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City | ROSWELL
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State | GA
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Zip | 30076-1523
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Country | US
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Telephone | 770-594-8003
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL R PITTS
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Credential | PSY.D.
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Telephone | 770-594-8003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY001830
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License Number State | GA
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