Doctor Name: | ANGELA M PEDRETTI |
NPI Number: | 1093930455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPC |
License Number: | LPC 1098 |
Business Practice Address: | 100 Polk County Plz Suite 50 Balsam Lake, WI - 548109071 |
Business Phone Number: | 7154858448 |
Business Fax Number: | 7154858490 |
Mailing Address: | 1998 Long Lake Lane, COMSTOCK |
State: | WI |
Postal Code: | 54826 |
Phone Number: | 7158228614 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC 1098 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | SD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |