Individual
DONNA PETTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
408 MULBERRY ST, BROWNWOOD, TX 76801-1639
(325) 643-1721
(325) 646-7627
Mailing address
233 COOPER DR, HURST, TX 76053-6128
(325) 203-0190
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100903
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189576501
—
TX
Enumeration date
08/06/2007
Last updated
09/28/2021
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