Individual
MICHELE LEE PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1902 W CHARLES ST, GRAND ISLAND, NE 68803-5905
(308) 390-1809
Mailing address
1902 W CHARLES ST, GRAND ISLAND, NE 68803-5905
(308) 390-1809
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB883769
NE
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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