Individual
MARY PETTIETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3223 N OLIVER ST, WICHITA, KS 67220-2106
(316) 558-3436
Mailing address
3223 N OLIVER ST, WICHITA, KS 67220-2106
(316) 558-3436
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-04038
KS
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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