Healthcare Provider Details

I. General information

NPI: 1326002866
Provider Name (Legal Business Name): KAREN R PETROSKI MA,LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 S PIKE RD
SARVER PA
16055-9202
US

IV. Provider business mailing address

617 S PIKE RD
SARVER PA
16055-9202
US

V. Phone/Fax

Practice location:
  • Phone: 724-766-9238
  • Fax: 724-295-9944
Mailing address:
  • Phone: 724-766-9238
  • Fax: 724-295-9944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF000048
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: