Individual
AYANNA PETTAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
7308 198TH ST FL 2, FRESH MEADOWS, NY 11366-1819
(917) 770-1890
Mailing address
7308 198TH ST FL 2, FRESH MEADOWS, NY 11366-1819
(917) 770-1890
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
008303
NY
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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