| William D Petok, Phd, Pa | |
|
479 Jumpers Hole Rd Suite 304b Severna Park MD 21146-1600 | |
| (410) 647-9166 | |
| (410) 647-9174 |
| Full Name | William D Petok, Phd, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 479 Jumpers Hole Rd, Severna Park, Maryland |
| Authorized Official Name and Position | William David Petok (PRESIDENT) |
| Authorized Official Contact | 4106479166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| William D Petok, Phd, Pa 479 Jumpers Hole Rd Suite 304b Severna Park MD 21146-1600 Ph: (410) 647-9166 | William D Petok, Phd, Pa 479 Jumpers Hole Rd Suite 304b Severna Park MD 21146-1600 Ph: (410) 647-9166 |
| NPI Number | 1124322185 |
|---|---|
| Provider Enumeration Date | 01/06/2011 |
| Last Update Date | 01/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124322185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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