Individual
MR. LARRY PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4303 CRICKLEWOOD ST, LUMBERTON, NC 28358-2406
(910) 738-1208
Mailing address
4303 CRICKLEWOOD ST, LUMBERTON, NC 28358-2406
(910) 738-1208
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
548
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111774
—
NC
Enumeration date
11/16/2005
Last updated
07/09/2012
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