Individual provider · Type 1 NPI
Brenda L. Petticrew, LMT
Specialist · Shannon, IL
NPI number
1568810331
Active
Practice location
409 S Hickory St
Shannon, IL 61078-9017
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 227.016348 (IL) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
About NPI 1568810331
Brenda L. Petticrew, LMT's National Provider Identifier is 1568810331, issued on Jun 2, 2016. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Shannon, IL. The record was last updated on Jun 2, 2016.