Individual provider · Type 1 NPI

Ashanti Minkah Pettaway

Mental Health Counselor · Chicago, IL

NPI number 1710729033 Active

Practice location

1147 W Ohio St
Chicago, IL 60642-6472

Fax (312) 561-6974

Mailing address

1631 W 102nd St
Chicago, IL 60643-2144

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1710729033

Ashanti Minkah Pettaway's National Provider Identifier is 1710729033, issued on Jun 7, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Chicago, IL. The record was last updated on Jun 7, 2024.