Petty, Julia Kathryn

Petty, Julia Kathryn is an individual health care provider with primary practice located at Rr 3 Box 414 , Lawrenceville IL 62439. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Petty, Julia Kathryn can be contacted via phone (618) 943-3754.

Contact Information

Primary practice address
Rr 3 Box 414 Lawrenceville IL 62439
Phone: (618) 943-3754
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1881821478
LBN Legal business name Petty, Julia Kathryn
Credentials BS, MSM
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2009
Last updated Jun 22nd, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881821478 NPPES
Illinois MEDICAID 37600178008

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