Pettway, Azalia
Pettway, Azalia is an individual health care provider with primary practice located at 1901 Lennox Dr , Eldersburg MD 21784-6699. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Pettway, Azalia can be contacted via phone (443) 403-9597.Contact Information
Primary practice address
1901 Lennox Dr
Eldersburg MD 21784-6699
Phone: (443) 403-9597
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C014221 | North Carolina |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 20296 | Maryland |
Profile Details
| NPI number | 1669149506 |
|---|---|
| LBN Legal business name | Pettway, Azalia |
| Credentials | LCSWC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 27th, 2021 |
| Last updated | Dec 14th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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