Individual provider · Type 1 NPI

Jennifer Nicole Petty

Mental Health Counselor · Portland, OR

NPI number 1396480893 Active

Practice location

621 SW Alder St Ste 520
Portland, OR 97205-3620

Fax (503) 494-4747

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1396480893

Jennifer Nicole Petty's National Provider Identifier is 1396480893, issued on Apr 29, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Apr 29, 2022.