Individual
MARISA PETRUCCELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 442-3028
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
9673
MA
Other
Enumeration date
02/07/2011
Last updated
02/02/2023
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