Individual
ASHANTI MINKAH PETTAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1147 W OHIO ST, CHICAGO, IL 60642-6472
(312) 772-9796
(312) 561-6974
Mailing address
1631 W 102ND ST, CHICAGO, IL 60643-2144
(678) 362-8079
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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