Individual
COURTNEY HAYNES PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
301 JEB SEAGLE DR, LINCOLNTON, NC 28092-2168
(704) 736-1626
Mailing address
200 E 2ND AVE, GASTONIA, NC 28052-4358
(704) 874-1900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PO18662
NC
Other
Enumeration date
06/21/2023
Last updated
12/28/2023
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