Individual
LAURA S. PETTIFOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
56647 NORTHRIDGE DR, MIDDLEBURY, IN 46540-9119
(574) 533-3151
Mailing address
56647 NORTHRIDGE DR, MIDDLEBURY, IN 46540-9119
(574) 533-3151
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1210541
IN
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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