Individual
STACEY PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3488 JEFFCO BLVD, ARNOLD, MO 63010-6015
(636) 464-5439
Mailing address
3488 JEFFCO BLVD, ARNOLD, MO 63010-6015
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2020030532
MO
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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