Individual
MR. MARK JOSEPH PETRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LMFT
Contact information
Practice address
7275 STATE FAIR BLVD, BALDWINSVILLE, NY 13027
(315) 638-9910
Mailing address
1 TRAVERS ST, BALDWINSVILLE, NY 13027
(315) 635-1396
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0000341
NY
Other
Enumeration date
08/28/2006
Last updated
07/08/2007
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