Provider Demographics
NPI:1033866009
Name:PITMAN, DANA DENISE (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:DENISE
Last Name:PITMAN
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 942
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:TX
Mailing Address - Zip Code:76442-0942
Mailing Address - Country:US
Mailing Address - Phone:409-659-0000
Mailing Address - Fax:
Practice Address - Street 1:101 ALAMO
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-2068
Practice Address - Country:US
Practice Address - Phone:409-659-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111653235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist