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Organization
MARY PETRO LCSW PLLC
Active
Organization
MARY PETRO LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY M PETRO LCSW (MEMBER)
(779) 910-5001
Entity
Organization
Contact information
Practice address
415 S MULFORD RD, ROCKFORD, IL 61108-3011
(779) 910-5001
(815) 399-5767
Mailing address
11166 FYVIE CT, BELVIDERE, IL 61008-7408
(779) 910-5001
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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