Individual
ANASTAJIA PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9120 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5845
(763) 501-4182
Mailing address
9120 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5845
(763) 501-4182
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
06/29/2023
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