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1003422049
TARA LEE PETROCHKO
NEW YORK, NY
NPI
1003422049
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 096265)
Enumeration Date
2020-09-16
Last Update Date
2023-10-10
Business Address
TARA LEE PETROCHKO LCSW
322 8TH AVE
NEW YORK, NY 10001-8001
Phone number: 212-283-2830
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Mailing Address
TARA LEE PETROCHKO LCSW
138 E 112TH ST APT 2D
NEW YORK, NY 10029-2670
Phone number: 646-281-1679
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