Healthcare Provider Details

I. General information

NPI: 1285525311
Provider Name (Legal Business Name): EMILY ELIZABETH PETRARCA ASSOCIATE MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N MAIN ST FL 5
ATTLEBORO MA
02703-2282
US

IV. Provider business mailing address

30 MAIN ST APT 2L
MANVILLE RI
02838-1425
US

V. Phone/Fax

Practice location:
  • Phone: 508-409-0000
  • Fax:
Mailing address:
  • Phone: 401-556-1885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT00041-A
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: