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Individual
JOSEPH DANIEL PETRUSO
Active
Individual
JOSEPH DANIEL PETRUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904000087
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
087912
ANTHEM BC/BS
VA
05
—
8937931
—
VA
Enumeration date
02/07/2006
Last updated
06/18/2008
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