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Individual

MRS. GINAH BRIANNE PETTYJOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
685 SHELBY TRL STE 105, CONWAY, AR 72034-7169
(501) 406-0504
Mailing address
501 E CENTERTON BLVD APT 1312, CENTERTON, AR 72719-7917
(479) 257-5070

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P1811147
AR

Other

Enumeration date
11/18/2016
Last updated
08/03/2023
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