Individual
MRS. ANGELA MICHELLE PETTITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L-SLP, CCC-SLP
Contact information
Practice address
23946 SOUTHPARK LN, DENHAM SPRINGS, LA 70726-6898
(225) 276-4190
Mailing address
PO BOX 1130, LIVINGSTON, LA 70754-1130
(225) 665-0446
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8502
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2644441
—
LA
Enumeration date
07/31/2020
Last updated
05/06/2024
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