Individual
DR. MARTHA DESCHAMPS PETOSKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
261 GREENGATE LN, SPARTANBURG, SC 29307-2211
(864) 494-0928
Mailing address
224 WILLING LAKES CT, ORANGEBURG, SC 29118-1861
(864) 384-9002
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
881
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WP8965
—
SC
Enumeration date
05/27/2006
Last updated
05/03/2013
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