Individual
MRS. NIESHA GWENDOLYN PITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8400 BUSTLETON AVE STE 6, PHILADELPHIA, PA 19152-1918
(215) 728-4930
(215) 728-4980
Mailing address
2031 N 62ND ST, PHILADELPHIA, PA 19151-3207
(215) 359-6334
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/23/2017
Last updated
08/31/2021
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