Individual
AZALIA PETTWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWC
Contact information
Practice address
1901 LENNOX DR, ELDERSBURG, MD 21784-6699
(443) 403-9597
Mailing address
6618 GLENVILLE DR, WHITSETT, NC 27377-9141
(443) 403-9597
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20296
MD
1041C0700X
Clinical Social Worker
C014221
NC
Other
Enumeration date
08/27/2021
Last updated
12/14/2021
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