Individual
MRS. MICHELLE LYNNE PETTIJOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.S.C.S.W.
Contact information
Practice address
5960 DEARBORN ST STE 1, MISSION, KS 66202-3342
(913) 645-6652
Mailing address
5960 DEARBORN ST STE 1, MISSION, KS 66202-3342
(913) 645-6652
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2213
KS
Other
Enumeration date
04/11/2009
Last updated
04/11/2009
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