Individual
MR. MARK PHILLIP PITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAP, CCJAP
Contact information
Practice address
17356 US HIGHWAY 301 N, STARKE, FL 32091-1619
(904) 827-7150
Mailing address
6629 VIRGINIA BEACH LANE, KEYSTONE HEIGHTS, FL 32656
(352) 475-2517
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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