Doctor Name: | MS. MELISSA PETTIT |
NPI Number: | 1346387461 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC-S |
License Number: | 16825 |
Business Practice Address: | 124 Royal Lane Ste A Uvalde, TX - 78801 |
Business Phone Number: | 8304865426 |
Business Fax Number: | |
Mailing Address: | 227 Myrtle St, UVALDE |
State: | TX |
Postal Code: | 788014231 |
Phone Number: | 8304865426 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 16825 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |