Individual
SHANNON NAYMON PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2041 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7024
(202) 547-8450
(202) 610-7147
Mailing address
1721 N VEITCH ST APT 1, ARLINGTON, VA 22201-3423
(571) 215-4515
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/18/2023
Last updated
07/19/2023
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