Individual
JACQUELYN PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
130 CARBONTON RD, SANFORD, NC 27330-4009
(919) 774-6521
Mailing address
2234 WALTER BRIGHT RD, SANFORD, NC 27330-0341
(919) 770-4588
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4807
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103319
—
NC
Enumeration date
01/24/2007
Last updated
08/01/2013
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