Provider Demographics
NPI:1215599535
Name:PITTS, JARRED MICHAEL
Entity Type:Individual
Prefix:
First Name:JARRED
Middle Name:MICHAEL
Last Name:PITTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-9369
Mailing Address - Country:US
Mailing Address - Phone:892-266-3415
Mailing Address - Fax:
Practice Address - Street 1:4600 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9369
Practice Address - Country:US
Practice Address - Phone:892-266-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician