Individual
HEATHER PETRENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
500 CLARK AVE STE Q, UNION, MO 63084-1004
(636) 249-7698
Mailing address
500 CLARK AVE STE Q, UNION, MO 63084-1004
(636) 249-7698
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2024032976
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
838042000
—
TN
Enumeration date
09/22/2006
Last updated
08/28/2024
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