Individual
KATIE PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
477 PROMINENCE CT STE 100, DAWSONVILLE, GA 30534-6377
(401) 216-9564
Mailing address
477 PROMINENCE CT STE 100, DAWSONVILLE, GA 30534-6377
(401) 216-9564
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP011567
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP011567
GA SLP LICENSE
GA
Enumeration date
06/12/2021
Last updated
07/29/2024
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