Individual
SHABRONAH PETTIFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5775 DEER RUN DR, FORT PIERCE, FL 34951-3343
(610) 564-1508
Mailing address
5775 DEER RUN DR, FORT PIERCE, FL 34951-3343
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
4746
FL
2355S0801X
Speech-Language Assistant
9305
CA
Other
Enumeration date
05/26/2025
Last updated
05/26/2025
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