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Individual
THERESA ELIZABETH PETROSKY
Active
Individual
THERESA ELIZABETH PETROSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CC6723
ME
101YM0800X
Mental Health Counselor
10200
OK
Other
Enumeration date
07/30/2019
Last updated
08/24/2022
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