Individual
DR. DEBORAH JEANNE PETKOVSEK REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4900 BROAD RIVER RD, SCDJJ -BWD CAMPUS, COLUMBIA, SC 29212-3531
(803) 896-9053
Mailing address
2906 BURNEY DR, COLUMBIA, SC 29205-3418
(803) 476-6799
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1038
SC
Other
Enumeration date
09/25/2006
Last updated
03/24/2009
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