| NPI | 1679181200 |
|---|---|
| Former Name | MONICA FAYE PETTWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 3655) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA 010848) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |