Most Relevant Information
Provider Data
| NPI Number: | 1003371667 |
| Provider Name: | JAMIE RAY PETTIT ED.D LPC - MHSP |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 2300 |
Most Important Dates
| Enumeration Date: | 02/07/2019 |
| Last Updated: | 03/20/2020 |
Provider Practice Location
6630 SUMMER KNOLL CIR
BARTLETT
TN
381342875
Practice Location Phone/Fax
| Phone: | 9017469438 |
| Fax: | 9017469331 |
Provider Mailing Location
6630 SUMMER KNOLL CIR STE 101
BARTLETT
TN
381342875
Provider Mailing Phone/Fax
| Phone: | 9017469438 |
| Fax: | 9017469331 |