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General NPI Number Information
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NPI Number | 1659251981
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Entity Type | Individual
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Provider Name | HOLLY PETRO MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1247 S CEDAR CREST BLVD STE 107
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City | ALLENTOWN
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State | PA
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Zip | 18103-6347
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Country | US
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Telephone | 484-202-0751
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Fax |
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Provider Business Mailing Address
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Address Line | 858 HILL ST
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-3421
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Country | US
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Telephone | 973-796-7297
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06561500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW142366
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License Number State | PA
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