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General NPI Number Information
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NPI Number | 1912129453
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Entity Type | Individual
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Provider Name | RUDOLF HARALD WILHELM PETRINI L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1301 CAROLINA ST SUITE 114
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City | GREENSBORO
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State | NC
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Zip | 27401-1032
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Country | US
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Telephone | 336-272-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 4797 SILVER CREEK DR
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City | GREENSBORO
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State | NC
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Zip | 27410-9594
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Country | US
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Telephone | 336-668-2459
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5437
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License Number State | NC
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