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Individual

LELA PETTWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
20 WOODLAWN COURT, 20 WOODLAWN COURT, BLUE RIGDE, VA 24064
(540) 314-0865
(888) 888-8888
Mailing address
20 WOODLAWN CT, 20 WOODLAWN COURT, BLUE RIDGE, VA 24064-1636
(540) 314-0865
(111) 111-1111

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
VA
101Y00000X
Counselor

Other

Enumeration date
03/02/2016
Last updated
03/02/2016
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