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General NPI Number Information
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NPI Number | 1407656358
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Entity Type | Individual
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Provider Name | MR. GARRICK DEMETRUS PITTS JR.
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Gender | Male
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 400 N REYNOLDS RD
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City | BRYANT
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State | AR
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Zip | 72022-3024
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Country | US
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Telephone | 501-613-0385
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Fax |
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Provider Business Mailing Address
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Address Line | 105 LOWERY ST APT 1110
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City | HOT SPRINGS
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State | AR
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Zip | 71901-7067
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Country | US
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Telephone | 501-209-0580
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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