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Individual

MS. JANE ELIZABETH PETTIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
3000 CONNECTICUT AVENUE NW, SUITE 304, WASHINGTON, DC 20008-2509
(202) 234-8101
Mailing address
4916 47TH ST NW, WASHINGTON, DC 20016-4006
(202) 237-9066
(202) 237-7068

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
111621
MA
1041C0700X
Clinical Social Worker
Primary
LC303178
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6972
BLUECROSS BLUESHIELD
DC
Enumeration date
01/08/2007
Last updated
07/08/2007
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