Individual
SUELI PETRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
671 HOES LN W, PISCATAWAY, NJ 08854-8021
(732) 565-9010
(732) 565-0703
Mailing address
328 DENISON ST, HIGHLAND PARK, NJ 08904-2732
(732) 565-9010
(732) 565-0703
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00447300
NJ
106H00000X
Marriage & Family Therapist
37FI00160800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4144007
—
NJ
Enumeration date
10/26/2006
Last updated
10/24/2012
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