Individual
JASON R PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC, LPO
Contact information
Practice address
1739 W PARNELL ST, DENISON, TX 75020-1123
(903) 816-2405
Mailing address
1739 W PARNELL ST, DENISON, TX 75020-1123
(903) 816-2405
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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