Individual
MRS. STACY LYNN PETTITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
340 NE MAPLE, PULLMAN, WA 99163
(509) 334-1133
(509) 334-1133
Mailing address
340 NE MAPLE, PULLMAN, WA 99163
(509) 334-1133
(509) 332-1608
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SA60567471
WA
Other
Enumeration date
09/29/2009
Last updated
06/04/2015
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