Doctor Name: | LORALIE PETITTI |
NPI Number: | 1003089194 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | PC004568 |
Business Practice Address: | 150 West Dubois Avenue Juniata Place Souite B Dubois, PA - 15801 |
Business Phone Number: | 8143757090 |
Business Fax Number: | 8143757940 |
Mailing Address: | 150 West Dubois Avenue, Juniata Place Souite B DUBOIS |
State: | PA |
Postal Code: | 15801 |
Phone Number: | 8143757090 |
Fax Number: | 8143757940 |
NPI Enumeration Date: | 04/09/2008 |
NPI Last Update Date: | 04/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC004568 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |