Shana Nicole Pettway

NPI #1750920369 in North Haven, Connecticut

Provider Information

NPI Number: 1750920369
Entity Type: Individual
Name: Shana Nicole Pettway
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 30, 2019
Last Updated: Dec 30, 2019

Practice Location

Address: 145 FITCH ST
City: North Haven
State: Connecticut
ZIP Code: 06473-3706
Phone: (203) 239-2564

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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