John W Petrie
Social Worker, Clinical in Red Bank, NJ. Individual provider (NPI-1).
NPI number1366164352
StatusActive
Last updated in NPPESSep 6, 2024
Details
- NPI
- 1366164352
- Entity type
- Individual (NPI-1)
- Name
- John W Petrie
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 15, 2022
- Certification date
- Sep 6, 2024
- Last updated
- Sep 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 44SC06384100 | NJ | Yes |
| 104100000X | Social Worker | – | – |
Practice location
65 Mechanic St Ste 203Red Bank, NJ 07701-1852
Phone 855-284-7483
Mailing address
Po Box 748465Atlanta, GA 30374-8465
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