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1699485540
KENNETH MICHAEL PETTIS
LODI, CA
NPI
1699485540
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 150072)
Enumeration Date
2022-12-01
Last Update Date
2024-10-15
Business Address
Mr. KENNETH MICHAEL PETTIS LMFT
315 W PINE ST #3, 95240
LODI, CA 95240-4094
Phone number: 209-366-2273
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Mailing Address
Mr. KENNETH MICHAEL PETTIS LMFT
5250 CLAREMONT AVE STE 118
STOCKTON, CA 95207-5700
Phone number: 719-200-2238
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