Individual
EBONY PETTIGREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
39 MURRAY GUARD DR, JACKSON, TN 38305-3610
(731) 736-4400
Mailing address
39 MURRAY GUARD DR, JACKSON, TN 38305-3610
(731) 736-4400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/04/2025
Last updated
07/20/2026
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