Pettit, Melinda Kay

Pettit, Melinda Kay is an individual health care provider with primary practice located at 104 Jordan Plaza Blvd Suite 402-403, Tyler TX 75704-2055. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Pettit, Melinda Kay can be contacted via phone (903) 581-9472.

Contact Information

Primary practice address
104 Jordan Plaza Blvd Suite 402-403 Tyler TX 75704-2055
Phone: (903) 581-9472
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 12348 Texas

Profile Details

NPI number 1437605342
LBN Legal business name Pettit, Melinda Kay
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2016
Last updated Aug 31st, 2016 - about 10 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 1437605342 NPPES
Texas Other 12348 LCDC

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