Individual
MRS. STEPHANIE PETTAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4903 CATALINA DR, TOLEDO, OH 43615-6115
(419) 578-8787
Mailing address
4903 CATALINA DR, TOLEDO, OH 43615-6115
(419) 578-8787
(419) 578-8787
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.2309637
OH
253Z00000X
In Home Supportive Care Agency
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497997
—
OH
Enumeration date
04/10/2023
Last updated
09/26/2024
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