Provider Demographics
NPI:1487425898
Name:PITTS, DENISE DARSEL
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:DARSEL
Last Name:PITTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1718
Mailing Address - Country:US
Mailing Address - Phone:216-820-8832
Mailing Address - Fax:
Practice Address - Street 1:1667 CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1718
Practice Address - Country:US
Practice Address - Phone:216-820-8832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRB722424172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver