Individual
MS. EMILY PETRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19-21 BELMONT AVE, DOVER, NJ 07801-4107
(973) 361-5555
(973) 361-5290
Mailing address
19-21 BELMONT AVE, DOVER, NJ 07801-4107
(973) 361-5555
(973) 361-5290
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
O356935
—
NJ
05
—
O419095
—
NJ
Enumeration date
03/01/2016
Last updated
03/01/2016
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