Individual
JENNIFER PETTWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
9315 TELEGRAPH RD, REDFORD, MI 48239-1260
(313) 450-4500
Mailing address
20021 GREENLAWN ST, DETROIT, MI 48221-1145
(313) 614-0282
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801105291
MI
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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