| Mary Petro Lcsw Pllc | |
|
415 S Mulford Rd Rockford IL 61108-3011 | |
| (779) 910-5001 | |
| (815) 399-5767 |
| Full Name | Mary Petro Lcsw Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 415 S Mulford Rd, Rockford, Illinois |
| Authorized Official Name and Position | Mary M Petro (MEMBER) |
| Authorized Official Contact | 7799105001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Petro Lcsw Pllc 11166 Fyvie Ct Belvidere IL 61008-7408 Ph: (779) 910-5001 | Mary Petro Lcsw Pllc 415 S Mulford Rd Rockford IL 61108-3011 Ph: (779) 910-5001 |
| NPI Number | 1447077615 |
|---|---|
| Provider Enumeration Date | 09/20/2024 |
| Last Update Date | 09/20/2024 |
| Certification Date | 09/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447077615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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