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Organization
VERONICA PETKUS, LLC
Active
Organization
VERONICA PETKUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA PETKUS LMHC (LICENSED MENTAL HEALTH COUNSELOR)
(386) 212-3643
Entity
Organization
Contact information
Practice address
418 TREEMONT DR, ORANGE CITY, FL 32763-7978
(386) 212-3643
Mailing address
418 TREEMONT DR, ORANGE CITY, FL 32763-7978
(386) 212-3643
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134530934
NPI INDIVIDUAL
FL
Enumeration date
04/03/2019
Last updated
06/11/2019
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