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Individual
MR. SHANE MAYLIN PITCHER
Active
Individual
MR. SHANE MAYLIN PITCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7036797-3502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7036797-3501
DOPL LISCENCE LCSW
UT
01
—
7036797-3502
DOPL LISCENCE
UT
Enumeration date
05/24/2010
Last updated
12/18/2020
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