Organization
PETTINGILL COUNSELING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA PETTINGILL LCSW (OWNER)
(208) 227-4600
Entity
Organization
Contact information
Practice address
1302 E 17TH ST, IDAHO FALLS, ID 83404-6270
(208) 542-9919
(208) 542-6272
Mailing address
1302 E 17TH ST, IDAHO FALLS, ID 83404-6270
(208) 542-9919
(208) 542-6272
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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