Individual
PAMELA R PETTIGREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10601 S WESTERN AVE STE 109, OKLAHOMA CITY, OK 73170
(405) 703-4420
(405) 703-4499
Mailing address
10601 S WESTERN AVE STE 109, OKLAHOMA CITY, OK 73170-6215
(405) 703-4420
(405) 703-4499
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1827
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649489626
NPI
OK
Enumeration date
05/22/2007
Last updated
10/23/2018
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