| Veronica Petkus, Llc | |
|
418 Treemont Dr Orange City FL 32763-7978 | |
| (386) 212-3643 | |
| Not Available |
| Full Name | Veronica Petkus, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 418 Treemont Dr, Orange City, Florida |
| Authorized Official Name and Position | Veronica Petkus (LICENSED MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 3862123643 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Veronica Petkus, Llc 418 Treemont Dr Orange City FL 32763-7978 Ph: (386) 212-3643 | Veronica Petkus, Llc 418 Treemont Dr Orange City FL 32763-7978 Ph: (386) 212-3643 |
| NPI Number | 1780146100 |
|---|---|
| Provider Enumeration Date | 04/03/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780146100 | NPI | - | NPPES |
| 1134530934 | Other | FL | NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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