Provider Demographics
NPI:1225279201
Name:PITT, ROSALYN RUTH (SPE)
Entity Type:Individual
Prefix:MRS
First Name:ROSALYN
Middle Name:RUTH
Last Name:PITT
Suffix:
Gender:F
Credentials:SPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 REN MAR DR STE 201-A
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-3722
Mailing Address - Country:US
Mailing Address - Phone:615-746-9977
Mailing Address - Fax:
Practice Address - Street 1:254 REN MAR DR STE 201-A
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-3722
Practice Address - Country:US
Practice Address - Phone:615-746-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE0000001589103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling