Individual
MS. THERESA F PETTAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
21105 SCHOOL VIEW RD, WAMEGO, KS 66547-9416
(785) 456-7326
Mailing address
21105 SCHOOL VIEW RD, WAMEGO, KS 66547-9416
(785) 456-7326
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1144
KS
Other
Enumeration date
04/19/2006
Last updated
07/16/2010
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