Individual
ANNE B PETITTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1710 HOLLY CREEK DR, TYLER, TX 75703-0907
(903) 617-6606
Mailing address
1710 HOLLY CREEK DR, TYLER, TX 75703-0907
(903) 617-6606
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1796
TX
101YP2500X
Professional Counselor
Primary
15485
TX
Other
Enumeration date
10/01/2013
Last updated
10/01/2013
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