Shawanda Lynette Petty

NPI #1942820121 in Marina, California

Provider Information

NPI Number: 1942820121
Entity Type: Individual
Name: Shawanda Lynette Petty
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Apr 17, 2020
Last Updated: Apr 17, 2020

Practice Location

Address: 601 BAYONET CIR
City: Marina
State: California
ZIP Code: 93933-4600
Phone: (831) 641-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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