Provider Demographics
NPI:1033947130
Name:PITCHER, MARA (MT #137140)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:PITCHER
Suffix:
Gender:F
Credentials:MT #137140
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7860 CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4544
Mailing Address - Country:US
Mailing Address - Phone:773-742-5260
Mailing Address - Fax:
Practice Address - Street 1:7951 COLLIN MCKINNEY PKWY APT 1500 SUITE 121
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:469-592-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT137140225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist