Most Relevant Information
Provider Data
| NPI Number: | 1003571977 |
| Provider Name: | EVELYN MAE PETTIGREW |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/04/2021 |
| Last Updated: | 11/04/2021 |
Provider Practice Location
1108 N WHEELER AVE
SALLISAW
OK
749552227
Practice Location Phone/Fax
| Phone: | 9187755513 |
| Fax: | 9187755526 |
Provider Mailing Location
1108 N WHEELER AVE
SALLISAW
OK
749552227
Provider Mailing Phone/Fax
| Phone: | 9187755513 |
| Fax: | 9187755526 |