Individual
ANNA PETTWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
025107
NY
103TC0700X
Clinical Psychologist
6301015173
MI
103TC0700X
Clinical Psychologist
6301018273
MI
2084P0804X
Child & Adolescent Psychiatry Physician
295925
NY
Other
Enumeration date
11/23/2013
Last updated
07/22/2023
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