Individual
MS. JAN ELLEN PITTARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
605 W MULBERRY ST, DECATUR, TX 76234-1263
(940) 627-5444
Mailing address
916 W COLLEGE ST, GRAPEVINE, TX 76051-5128
(817) 680-0015
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109612
TX
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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