TISHA PETELO's National Provider Identifier (NPI) Details
TISHA PETELO, LCSW, MAC
NPI: 1487980611
Enumeration Date: 2009-10-22
Last updated: 2009-10-22
Sole Proprietor: NO
Status: active
Postal Address: PO BOX 1005, PAGO PAGO, AS
Phone: 684-699-3725
Primary Practice Address: FIATELE TEO BLDG., AIRPORT ROAD 1005, PAGO PAGO, AS
Practice's phone: 684-699-3725