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Organization
MY OWN COUNSELOR
Active
Organization
MY OWN COUNSELOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE PETTITT LPC (MANAGER)
(469) 877-6190
Entity
Organization
Contact information
Practice address
1101 RIDGE RD, 102, ROCKWALL, TX 75087-4250
(469) 877-6190
Mailing address
1101 RIDGE RD, 102, ROCKWALL, TX 75087-4250
(469) 877-6190
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
68526
TX
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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