Doctor Name: | MISS JULIE LOUISE PETKOVSEK |
NPI Number: | 1356603302 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW-S |
License Number: | I0900211 |
Business Practice Address: | 7955 Elmhurst Dr Broadview Heights, OH - 441471221 |
Business Phone Number: | 3302424558 |
Business Fax Number: | |
Mailing Address: | 7955 Elmhurst Dr, BROADVIEW HEIGHTS |
State: | OH |
Postal Code: | 441471221 |
Phone Number: | 3302424558 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2012 |
NPI Last Update Date: | 06/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I0900211 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |