Provider Demographics
NPI:1538414842
Name:FITCH, PETER WARNER
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:WARNER
Last Name:FITCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HIGHFIELD CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-7965
Mailing Address - Country:US
Mailing Address - Phone:702-235-3060
Mailing Address - Fax:
Practice Address - Street 1:1515 HIGHFIELD CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7965
Practice Address - Country:US
Practice Address - Phone:702-235-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst