Individual
MR. DALE R PETRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 AVENUE C, DANVILLE, IL 61832-5410
(217) 442-3200
Mailing address
1116 WAVERLY DR, CHAMPAIGN, IL 61821-5011
(217) 359-0559
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-005478
IL
Other
Enumeration date
08/12/2010
Last updated
10/05/2012
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