Individual
DR. WILLIAM MARK PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1179
(208) 422-1241
Mailing address
904 W BRAEMERE RD, BOISE, ID 83702-1313
(208) 422-1179
(208) 422-1241
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-228
ID
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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