Samantha N Pettaway

NPI #1629444583 in Bayou La Batre, Alabama

Provider Information

NPI Number: 1629444583
Entity Type: Individual
Name: Samantha N Pettaway
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Enumeration Date: Aug 14, 2015
Last Updated: Jun 4, 2020

Practice Location

Address: 13833 TAPIA AVE
City: Bayou La Batre
State: Alabama
ZIP Code: 36509-2515
Phone: (251) 450-2211

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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