Individual
MR. DENNIS GUY PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1124 S 6TH ST, SPRINGFIELD, IL 62703-2406
(217) 523-3143
(217) 523-7695
Mailing address
1124 S 6TH ST, SPRINGFIELD, IL 62703-2406
(217) 523-3143
(217) 523-7695
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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