NPI 1023518214

Anthony Dwain Pettus

Practitioner Behavior Technician Madison, AL

Practice location

Address: 100 Spenryn Dr, Madison, AL 35758-1890
Phone: (256) 772-4400

Registered specialties (2)

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence 19-88268 (AL)

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Case Manager/Care Coordinator

Other Service Providers Taxonomy 171M00000X

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Registry record

NPI: 1023518214
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Feb 2018
Record last updated: 12 Jun 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.