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Individual

MS. CAROL PETOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., L.C.P.C.

Contact information

Practice address
770 PORT ST, EASTON, MD 21601-8102
(410) 819-3395
(410) 770-5813
Mailing address
1200 S WASHINGTON ST, #1006, EASTON, MD 21601-4351
(410) 770-5813
(410) 770-5813

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC2728
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
774800100
MD
Enumeration date
05/21/2008
Last updated
03/29/2011
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