Individual
KATHERINE HELEN PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3333 IRIS AVE STE 104, BOULDER, CO 80301-1998
(720) 204-8744
Mailing address
PO BOX 147, LONGMONT, CO 80502-0147
(720) 204-8744
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
PSY.0006156
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/26/2019
Last updated
03/06/2024
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