Individual
MRS. ANDREA EDITH LOUISE PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 BROADWAY STE 301, TACOMA, WA 98402-4454
(253) 292-4354
Mailing address
5338 IDAHO AVE, JOINT BASE LEWIS MCCHORD, WA 98433-1141
(407) 552-1202
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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