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Individual
MRS. TINA YVONNE PETTIFORD
Active
Individual
MRS. TINA YVONNE PETTIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
178.006219
IL
101YM0800X
Mental Health Counselor
178.006219
IL
101YP2500X
Professional Counselor
Primary
178.006219
IL
101YS0200X
School Counselor
2341716
IL
106H00000X
Marriage & Family Therapist
178.006219
IL
Other
Enumeration date
12/27/2011
Last updated
12/27/2011
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