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General NPI Number Information
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NPI Number | 1629610753
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Entity Type | Individual
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Provider Name | DAESHA L PITTS (CPB) CERTIFIED PROF
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Gender | Female
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 511 E 12TH ST
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City | CHESTER
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State | PA
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Zip | 19013-6116
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Country | US
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Telephone | 302-883-7787
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Fax |
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Provider Business Mailing Address
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Address Line | 312 THOMAS DAVIS DR
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City | CLAYTON
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State | DE
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Zip | 19938-2578
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Country | US
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Telephone | 302-883-7787
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 826112
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License Number State | PA
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