| Doctor Name: | MS. JANICE SUE PETTIGREW |
| NPI Number: | 1598991705 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., M.ED. |
| License Number: | 3121757 |
| Business Practice Address: | 111 Main St Sells, AZ - 85634 |
| Business Phone Number: | 5203836746 |
| Business Fax Number: | 5203835441 |
| Mailing Address: | Po Box 248, SELLS |
| State: | AZ |
| Postal Code: | 856340248 |
| Phone Number: | 5203836746 |
| Fax Number: | 5203835441 |
| NPI Enumeration Date: | 06/02/2009 |
| NPI Last Update Date: | 06/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 3121757 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |