Individual
TAKEISHALYN D PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NONE
Contact information
Practice address
3700 NW CLASSEN SUITE 240, OKLAHOMA CITY, OK 73118-2860
(405) 606-8406
(405) 606-8194
Mailing address
3700 NW CLASSEN SUITE 240, OKLAHOMA CITY, OK 73118-2860
(405) 606-8406
(405) 606-8194
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200079250A
—
OK
Enumeration date
04/21/2010
Last updated
04/21/2010
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