Individual
TANYA MARIE PETCOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP, MA
Contact information
Practice address
33493 W 14 MILE RD STE 130, FARMINGTON HILLS, MI 48331-1587
(248) 851-5437
(248) 592-1378
Mailing address
485 PARK ST, BIRMINGHAM, MI 48009-3402
(248) 219-5909
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301012794
MI
Other
Enumeration date
02/23/2007
Last updated
07/21/2022
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