Individual
JESSICA PAIGE PETHTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 569-4300
Mailing address
PO BOX 2603, FORT WORTH, TX 76113-2603
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
67202
TX
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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