Individual
DR. WILLIAM DAVID PETOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
479 JUMPERS HOLE RD, SUITE 304B, SEVERNA PARK, MD 21146-1600
(410) 647-9166
(410) 647-9174
Mailing address
479 JUMPERS HOLE RD, SUITE 304B, SEVERNA PARK, MD 21146-1600
(410) 647-9166
(410) 647-9174
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1349
MD
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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