Individual
DARIUS D PETTWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 210061, DALLAS, TX 75211-0061
(214) 945-0642
Mailing address
PO BOX 210061, DALLAS, TX 75211-0061
(214) 945-0642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
68071
TX
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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