Individual provider · Type 1 NPI

Shaunda Rena Petty

Mental Health Counselor · Tyler, TX

NPI number 1447145453 Active

Practice location

719 W Front St Ste 262
Tyler, TX 75702-7975

Call (903) 636-3868 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X96260 (TX)

Mental Health Counselor: Definition to come...

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About NPI 1447145453

Shaunda Rena Petty's National Provider Identifier is 1447145453, issued on Jun 10, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Tyler, TX. The record was last updated on Jun 10, 2025.