Individual
MISS TIFFANY ANNE PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
5372B OLD VIRGINIA ST, URBANNA, VA 23175
(804) 758-5250
Mailing address
PO BOX 40, SALUDA, VA 23149-0040
(804) 758-5250
(804) 758-5183
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
17100000X
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49-78137
—
VA
Enumeration date
08/02/2013
Last updated
08/02/2013
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