Individual
ARCHIE MAURICE PETTRY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
701 ANTLER DR STE 110, CASPER, WY 82601-1747
(307) 466-8008
Mailing address
701 ANTLER DR STE 110, CASPER, WY 82601-1747
(307) 466-8008
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-1522
WY
101YP2500X
Professional Counselor
Primary
LPC-1522
WY
Other
Enumeration date
05/20/2013
Last updated
05/22/2024
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