Individual
JACITA BOOKER PETWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
13815 PROFESSIONAL CENTER DR STE 100, HUNTERSVILLE, NC 28078-7951
(704) 384-1320
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
7089
NC
103T00000X
Psychologist
Primary
LPA# 3738
NC
Other
Enumeration date
04/08/2009
Last updated
06/09/2026
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