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General NPI Number Information
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NPI Number | 1669392536
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Entity Type | Organization
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Legal Business Name | TAMARA PETTIT, LLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 100 E GRANADA BLVD STE 103
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City | ORMOND BEACH
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State | FL
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Zip | 32176-6660
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Country | US
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Telephone | 386-999-1989
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Fax |
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Provider Business Mailing Address
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Address Line | 129 MAGNOLIA DR
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City | ORMOND BEACH
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State | FL
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Zip | 32176-8114
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Country | US
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Telephone | 386-785-4595
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | TAMARA FIELDS PETTIT
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Credential | MS, LMFT
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Telephone | 386-785-4595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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