Individual
ALICE D PETTY-HANNUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
406 CHINN ST, SANTA ROSA, CA 95404-4339
(707) 495-5350
(707) 570-2680
Mailing address
406 CHINN ST, SANTA ROSA, CA 95404-4339
(707) 495-5350
(707) 570-2680
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
43967
CA
Other
Enumeration date
06/11/2007
Last updated
08/25/2011
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