| Petra Therapeutic | |
|
9332 Annapolis Rd Ste 304 Lanham MD 20706-3168 | |
| (301) 731-2823 | |
| (301) 731-2833 |
| Full Name | Petra Therapeutic |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 9332 Annapolis Rd Ste 304, Lanham, Maryland |
| Authorized Official Name and Position | Darryl Marshall (OWNER) |
| Authorized Official Contact | 3017312823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petra Therapeutic 9332 Annapolis Rd Ste 304 Lanham MD 20706-3168 Ph: (301) 731-2823 | Petra Therapeutic 9332 Annapolis Rd Ste 304 Lanham MD 20706-3168 Ph: (301) 731-2823 |
| NPI Number | 1447636386 |
|---|---|
| Provider Enumeration Date | 08/03/2015 |
| Last Update Date | 08/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447636386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 17942 (Maryland) | Primary |
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