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1093592784
NISHERAH LAEBONY PETTAWAY
RANCHO CUCAMONGA, CA
NPI
1093592784
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-09-14
Last Update Date
2023-09-14
Business Address
NISHERAH LAEBONY PETTAWAY
7161 EAST AVE APT 21
RANCHO CUCAMONGA, CA 91739-5916
Phone number: 909-749-3674
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Mailing Address
NISHERAH LAEBONY PETTAWAY
7161 EAST AVE APT 21
RANCHO CUCAMONGA, CA 91739-5916
Phone number: 909-749-3674
Copy
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