Individual provider · Type 1 NPI

Shane Tyler Pettis

Peer Specialist · Amherst, NY

NPI number 1386214807 Active

Practice location

1412 Sweet Home Rd Ste 3-5
Amherst, NY 14228-2795

Call (716) 589-1411 Map

Fax (716) 276-3051

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1386214807

Shane Tyler Pettis's National Provider Identifier is 1386214807, issued on Jun 28, 2021. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Amherst, NY. The record was last updated on Jun 28, 2021.