NPI 1487980611

Tisha Petelo, LCSWMAC

Practitioner Clinical Social Worker Pago Pago, AS

Practice location

Address: Fiatele Teo Bldg. Airport Road 1005, Pago Pago, AS 96799-1005
Phone: (684) 699-3725
Mailing address: PO Box 1005, Pago Pago, AS 96799-1005

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 809 (CO)

Other Social Worker providers in American Samoa →

Registry record

NPI: 1487980611
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Oct 2009
Record last updated: 22 Oct 2009

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.