Individual
KATHERINE A PETEFISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, LCPC, BCBA LBA
Contact information
Practice address
10719 BUCKEYE RD, FESTUS, MO 63028-2960
(314) 319-7098
(636) 789-9062
Mailing address
10719 BUCKEYE RD, FESTUS, MO 63028-2960
(314) 319-7098
(636) 789-9062
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180009917
IL
103K00000X
Behavior Analyst
11517918
IA
103K00000X
Behavior Analyst
Primary
2015044940
MO
104100000X
Social Worker
008326
IA
251S00000X
Community/Behavioral Health Agency
—
MO
Other
Enumeration date
07/24/2013
Last updated
05/12/2020
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