Individual
DR. BERNAQDINE ANN PETZOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
524 E 4TH ST, ROYAL OAK, MI 48067-2847
(800) 963-9163
Mailing address
524 E 4TH ST, ROYAL OAK, MI 48067-2847
(248) 765-5735
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6401005086
MI
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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