Individual
DR. JAMIE PETTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
6601 BLALOCK FOREST DR, WILLOW SPRING, NC 27592-8977
(540) 447-0091
Mailing address
6601 BLALOCK FOREST DR, WILLOW SPRING, NC 27592-8977
(540) 447-0091
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2709
OR
103TC0700X
Clinical Psychologist
0810005815
VA
103TC0700X
Clinical Psychologist
Primary
6537
NC
Other
Enumeration date
05/17/2012
Last updated
08/27/2024
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