Individual
MRS. ADRIENNE ROMAYNE PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
12100 OLD HALLS FERRY RD, BLACK JACK, MO 63033-7112
(314) 441-6679
Mailing address
4883 BRISTOL ROCK RD, BLACK JACK, MO 63033-7104
(314) 441-6679
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2017043874
MO
Other
Enumeration date
09/21/2020
Last updated
11/27/2023
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