Individual
RANDI JO PETRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
29384 KENDALL RD, MACON, MO 63552-3657
(660) 591-5599
Mailing address
29384 KENDALL RD, MACON, MO 63552-3657
(660) 591-5599
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011038487
MO
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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