| NPI | 1124581160 |
|---|---|
| Other Name | SELENA MARIE PETTIT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: QMHS) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2025-01-29 |