Provider Demographics
NPI:1063089696
Name:PITTS, CHRISTINA MARIE (OTD, OTR)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:PITTS
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 MISTY DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-5065
Mailing Address - Country:US
Mailing Address - Phone:912-532-0650
Mailing Address - Fax:
Practice Address - Street 1:10144 FORD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3936
Practice Address - Country:US
Practice Address - Phone:912-727-2321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007758225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist