Provider Demographics
NPI:1912076340
Name:PITTI, JOANN MARIA (COTA)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:MARIA
Last Name:PITTI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 LAURENS LN
Mailing Address - Street 2:
Mailing Address - City:GRIMSLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38565-6003
Mailing Address - Country:US
Mailing Address - Phone:931-863-8302
Mailing Address - Fax:
Practice Address - Street 1:444 ONE ELEVEN PL
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-4358
Practice Address - Country:US
Practice Address - Phone:931-525-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1425224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant