Individual
DERRELL RASHAD PETTIWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSWA
Contact information
Practice address
2515 E NC HIGHWAY 54 BLDG 2200, DURHAM, NC 27713-5251
(919) 493-0959
Mailing address
2000 YONKERS RD, RALEIGH, NC 27604-2258
(919) 493-0959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P010476
NC
1041S0200X
School Social Worker
1199035
NC
Other
Enumeration date
06/24/2016
Last updated
07/13/2016
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