Individual
COURTNEY PETLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4318 BOONES BLUFF WAY, CHESTERFIELD, VA 23832-7694
(804) 339-6121
Mailing address
4318 BOONES BLUFF WAY, CHESTERFIELD, VA 23832-7694
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0904006775
VA
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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