Mallory E Pettengill, BA IN HEALTH

NPI #1861063182 in North Saint Paul, Minnesota

Provider Information

NPI Number: 1861063182
Entity Type: Individual
Name: Mallory E Pettengill, BA IN HEALTH
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Credential: BA IN HEALTH
Enumeration Date: Jul 7, 2021
Last Updated: Jul 7, 2021

Practice Location

Address: 2344 HELEN ST N
City: North Saint Paul
State: Minnesota
ZIP Code: 55109-2942
Phone: (952) 746-5350

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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