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Individual

MS. LAURA PETIFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP, LMFT

Contact information

Practice address
1525 KINGS HWY, SUITE 206, FAIRFIELD, CT 06824-5321
(203) 445-6238
Mailing address
66 BEAUMONT ST, FAIRFIELD, CT 06824-5748

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
001309
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
006417
CT

Other

Enumeration date
04/28/2009
Last updated
03/07/2016
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