Provider Demographics
NPI:1760046783
Name:PITTS, ASHLEY MICHALA (MMT, MMP, CMLDT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MICHALA
Last Name:PITTS
Suffix:
Gender:F
Credentials:MMT, MMP, CMLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W SEVIER ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-3658
Mailing Address - Country:US
Mailing Address - Phone:479-214-0888
Mailing Address - Fax:
Practice Address - Street 1:1007 W MAIN ST STE 2G
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-3416
Practice Address - Country:US
Practice Address - Phone:479-214-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8718225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist