Provider Demographics
NPI:1871681486
Name:VIRTS, KITTI L (PHD)
Entity Type:Individual
Prefix:DR
First Name:KITTI
Middle Name:L
Last Name:VIRTS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 BARLIN DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3443
Mailing Address - Country:US
Mailing Address - Phone:615-646-1450
Mailing Address - Fax:615-322-1578
Practice Address - Street 1:108 HARDING PL
Practice Address - Street 2:SUITE 200C
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-3704
Practice Address - Country:US
Practice Address - Phone:615-848-8214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2207103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3982165Medicare PIN