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Individual

MRS. MARY PETITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTL

Contact information

Practice address
406 WYOMING RD, OWINGSVILLE, KY 40360-8906
(606) 674-6613
Mailing address
406 WYOMING RD, OWINGSVILLE, KY 40360-8906
(606) 674-6613

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
225XG0600X
Gerontology Occupational Therapist

Other

Enumeration date
05/10/2017
Last updated
08/30/2017
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