Individual
TRINAE' PETTAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1072 CONKLIN ST, HOUSTON, TX 77088-5100
(504) 908-6802
Mailing address
1072 CONKLIN ST, HOUSTON, TX 77088-5100
(504) 908-6802
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
07/01/2023
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