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Individual

KIMBERLY JO PETTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
21350 W 153RD ST, OLATHE, KS 66061-5413
(913) 277-0646
Mailing address
805 E 133RD TER, GRANDVIEW, MO 64030-2907
(816) 719-0455

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11500
KS

Other

Enumeration date
03/03/2020
Last updated
03/19/2026
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