| Marden Petrie, Psyd, Pllc | |
|
6592 N Oracle Rd Tucson AZ 85704-5640 | |
| (520) 488-4602 | |
| (888) 429-6085 |
| Full Name | Marden Petrie, Psyd, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 6592 N Oracle Rd, Tucson, Arizona |
| Authorized Official Name and Position | Marden Petrie (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5204884602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marden Petrie, Psyd, Pllc 11114 N Falling Rain Rd Oro Valley AZ 85737-7321 Ph: (520) 488-4602 | Marden Petrie, Psyd, Pllc 6592 N Oracle Rd Tucson AZ 85704-5640 Ph: (520) 488-4602 |
| NPI Number | 1831551696 |
|---|---|
| Provider Enumeration Date | 03/22/2016 |
| Last Update Date | 04/07/2023 |
| Certification Date | 04/07/2023 |
| Medicare PECOS PAC ID | 0042517302 |
|---|---|
| Medicare Enrollment ID | O20160331002156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831551696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 4231 (Arizona) | Primary |
| Provider Name | Marden Petrie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760663066 PECOS PAC ID: 6204133572 Enrollment ID: I20160331002325 |
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