Individual
MAEGAN LAVERN PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 W MARKET ST, BLOOMINGTON, IL 61701-3918
(309) 827-5351
(309) 829-6808
Mailing address
108 W MARKET ST, BLOOMINGTON, IL 61701-3918
(309) 827-5351
(309) 829-6808
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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